scholarly journals Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

2020 ◽  
Author(s):  
Laxman Datt Bhatt ◽  
Shankar Singh Dhami ◽  
Dipendra Kumar Yadav
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Social Health ◽  
Insurance Status ◽  
Community Based ◽  
Health Security

Abstract Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method. Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group. Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

scholarly journals Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

2019 ◽  
Author(s):  
Laxman Datt Bhatt ◽  
Shankar Singh Dhami
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Social Health ◽  
Insurance Status ◽  
Community Based ◽  
Health Security

Abstract Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias.Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method.Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group.Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

scholarly journals Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

2019 ◽  
Author(s):  
Laxman Datt Bhatt ◽  
Shankar Singh Dhami ◽  
Dipendra Kumar Yadav
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Social Health ◽  
Insurance Status ◽  
Community Based ◽  
Health Security

Abstract Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias.Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method.Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group.Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

scholarly journals Health literacy and health outcomes in China’s floating population: mediating effects of health service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Mediating Effect ◽  
Floating Population ◽  
Equation Modeling ◽  
Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

Community-Based Health Coaching, Exercise, and Health Service Utilization

2005 ◽  
Vol 17 (6) ◽  
pp. 697-716 ◽  
Author(s):  
Stephen K. Holland ◽  
Jay Greenberg ◽  
Lynette Tidwell ◽  
Joelyn Malone ◽  
Joseph Mullan ◽  
...  
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Coaching ◽  
Community Based

scholarly journals Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Tewachew Muche Liyeh ◽  
Yitayal Ayalew Goshu ◽  
Habtamu Gebrehana Belay ◽  
Habtamu Abie Tasew ◽  
Gedefaye Nibret Mihiretie ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Service ◽  
Health Issues ◽  
Reproductive Health Services ◽  
Amhara Region

Introduction. Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. Method. An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. Results. Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education ( AOR = 2.55 , 95 % CI = 1.97 ‐ 5.62 ), attitude towards youth reproductive health services ( AOR = 2.74 , 95 % CI = 2.07 ‐ 5.30 ), those who had a habit of communicating on sexual and reproductive health issues with their family ( AOR = 3.66 , 95 % CI = 3.59 ‐ 7.41 ), discussion on sexual and reproductive health issue with peers/friends ( AOR = 1.43 , 95 % CI = 1.01 ‐ 2.02 ), respondents with good knowledge on youth reproductive health services ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ), and those who had faced reproductive health problems ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ) were significantly associated with youth reproductive health service utilization. Conclusion. Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.

O25. The Impact of a Community Based Intervention for People with Arthritis on Quality of Life and Health Service Utilization

Rheumatology ◽  
2014 ◽  
Vol 53 (suppl_1) ◽  
pp. i40-i40
Author(s):  
Chandrika Gordon ◽  
Rebecca J. Stack ◽  
Marilyn Robinson ◽  
Karim Raza ◽  
Ishraga Awad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Community Based ◽  
The Impact

scholarly journals Pattern of Outpatient Health Service Utilization by Older People in Iran

Salmand ◽  
2021 ◽  
Vol 15 (4) ◽  
pp. 410-427
Author(s):  
Maryam Tajvar ◽  
◽  
Mehdi Yaseri ◽  
Badriye Karami ◽  
Mariya Mohammadi ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Older People ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Planning ◽  
The Elderly ◽  
National Study ◽  
Outpatient Services ◽  
To Receive

Objectives: Considering the rapid growth of Iran’s elderly population with consequent increase in the costs of health services, it is necessary to be aware of the pattern of outpatient health service utilization, in the elderly for resource allocation and health planning. This study aims to determine the pattern of outpatient service utilization for the elderly in Iran and explore determinant factors. Methods & Materials: This is a cross-sectional study using secondary analysis method and the data from 2015 National Study of Health Service Utilization. Study population consists of older people aged ≥60 years. Of these, 8205 were selected as study samples. The data were collected using personal and household questionnaires collecting information on subjects’ need for, referral to, utilization from, and satisfaction with outpatient services. Logistic regression analysis was used to identify factors related to the need, referral, benefit, and satisfaction with the received outpatient services. Results: Out of 8205 participants, 3172 (39%) reported the need for outpatient services, of which 66% referred for services; of these, 98% (N=2060) benefited outpatient services. Females, older subjects, villagers, unmarried and illiterate subjects were more in need of outpatient services, but their referrals to receive the services were not more than those of other groups. Lack of basic insurance, supplementary insurance, and a personal care had a significant impact on reducing the number of subjects referred to receive outpatient services. Inability to pay treatment costs (30%), self-treatment (28%) and lack of proper insurance coverage (13%) were the most important reasons for not referring to receive outpatient services. The highest satisfaction was related to the behavior of physicians and medical staff and the lowest satisfaction was related to the cost of outpatient services. Conclusion: Although the use of outpatient health services should be based on the need for these services, the present study showed that the older people with higher socio-economic status had higher utilization from the services in Iran. Therefore, there is an inequality in access to outpatient services in the elderly. The reasons for not using outpatient services and dissatisfaction with these services should be seriously considered by health policy makers.

scholarly journals Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey

2020 ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Anao Zhang ◽  
Liming Fang ◽  
Yingxue Zhu
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Services Utilization ◽  
Middle Aged ◽  
Cross Sectional ◽  
Services Utilization

Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

scholarly journals Pemanfaatan Pelayanan Kesehatan oleh Perempuan Terinfeksi HIV/AIDS

2013 ◽  
Vol 8 (1) ◽  
pp. 33 ◽  
Author(s):  
Rialike Burhan
Keyword(s):  
Social Support ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Predisposing Factors ◽  
Research Approach ◽  
Enabling Factors ◽  
Living With Hiv ◽  
Hiv Aids

Perempuan terinfeksi human immunodeficiency virus dan acquired immune deficiency syndrome (HIV/AIDS) mempunyai permasalahan yang kompleks sehubungan dengan penyakit dan statusnya, sehingga mereka mempunyai kebutuhan yang khusus. Kebutuhan perawatan, dukungan dan pengobatan tersebut dapat diperoleh dengan mengakses pelayanan kesehatan yang tersedia untuk dapat mengoptimalkan kesehatan mereka sehingga dapat meningkatkan kualitas hidup. Tujuan penelitian ini untuk menganalisis hubungan faktor predisposisi yang meliputi pengetahuan, sikap, stigma, faktor pemungkin yang meliputi jarak ke pelayanan kesehatan dan faktor penguat berupa dukungan sosial dengan pemanfaatan pelayanan kesehatan pada perempuan terinfeksi HIV/AIDS. Rancangan penelitian menggunakan pendekatan potong lintang. Penelitian dilaksanakan di Kelompok Dukungan Sebaya Female Plus Kota Bandung pada bulan Juni sampai Juli 2012. Sampel penelitian berjumlah 40 orang perempuan terinfeksi HIV/AIDS. Data di analisis secara univariat, bivariat, dan multivariat. Hasil penelitian ini didapatkan bahwa terdapat hubungan yang signifikan secara statistik yaitu usia, pendidikan, status perkawinan, status pekerjaan, faktor predisposisi (pengetahuan, sikap, stigma), faktor penguat (dukungan sosial), dan faktor pemungkin yaitu jarak ke pelayanan kesehatan tidak berhubungan dengan pemanfaatan pelayanan kesehatan. Pengetahuan merupakan faktor penentu dalam pemanfaatan pelayanan kesehatan berpeluang 60,1 kali untuk memanfaatkan pelayanan kesehatan.Women living with HIV/AIDS have a complex problems who connection with the disease and her status, because they have special needs, for care, support and treatment can be obtained by accessing the health services available to optimize their health so as to improve the quality of life. The purpose of this study was to analyze the correlation between three factors, predisposing factors (knowledge, attitudes, stigma), enabling factors (distance to health services), and reinforcing factors (social support) with health service utilization.This type of research was analytic with cross-sectional research approach. The research was implemented in Female Plus Peer Support Group Bandung from June until July 2012. The sample in this study were 40 women living with HIV/AIDS. Data analysis using univariate, bivariate, and multivariate. The results obtained that there were significant relationship is age, education, marital status, work, predisposing factors (knowledge, attitude, stigma), reinforcing factor (social support), and enabling factors (distance to health services were not correlated with health service utilization). Knowledge was the determinant factor to health service utilization in 60,1 times the chance to utilize health services.

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