MEDICAL SERVICE UTILIZATION IN PHU LOC DISTRICT, THUA THIEN HUE PROVINCE

2014 ◽  
pp. 105-115
Author(s):  
Ngoc Thuy Nguyen ◽  
Thi Hoa Nguyen ◽  
Minh Tam Nguyen
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Medical Service ◽  
Health Facilities ◽  
Assessment Tools ◽  
Medical Services ◽  
Services Utilization ◽  
Care Assessment ◽  
Medical Services Utilization

Objectives: 1. To explore the utilization of medical services in Phu Loc District, Thua Thien Hue Province; 2. To examine some related factors to medical services utilization in Phu Loc District, Thua Thien Hue Province. Methods: A cross sectional study using questionnaire interview of 3258 residents in 800 households. Results: There were 352 people got sick during the one month period before interview of whom 95,3% respondents were sick one time and most cases were mild illness (60,5%). Respiratory problems accounted for the largest proportion. Among sick people, 33,8% of them used medical services at Commune Health Center (CHC), 20,2% treated at hospital, 12,8% used private clinic; and self treatment was still high (33,2%). Age group, the perceived serious level of illness, and having health insurance are significantly associated with the medical services utilization. The main reasons for using CHC are having health insurance (83,2%) and that CHC is near their home (75,6%). The major reason for not using CHC is the low quality of medical service at CHC (45,9%). Waiting time, the trust to medical staff, and satisfaction with consultation time are associated with the choice of health facilities. When assessing the quality of primary care of health facilities using the Primary Care Assessment Tools (PCAT), CHC had the highest score in the Comprehensiveness domain and the private clinics achieved the highest score in the Ongoing Care domain.

scholarly journals Performance of primary care in different healthcare facilities: a cross-sectional study of patients’ experiences in Southern Malawi

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029579
Author(s):  
Luckson Dullie ◽  
Eivind Meland ◽  
Øystein Hetlevik ◽  
Thomas Mildestvedt ◽  
Stephen Kasenda ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
Health Centres ◽  
Care Performance

ObjectiveIn most African countries, primary care is delivered through a district health system. Many factors, including staffing levels, staff experience, availability of equipment and facility management, affect the quality of primary care between and within countries. The purpose of this study was to assess the quality of primary care in different types of public health facilities in Southern Malawi.Study designThis was a cross-sectional quantitative study.SettingThe study was conducted in 12 public primary care facilities in Neno, Blantyre and Thyolo districts in July 2018.ParticipantsPatients aged ≥18 years, excluding the severely ill, were selected to participate in the study.Primary outcomesWe used the Malawian primary care assessment tool to conduct face-to-face interviews. Analysis of variance at 0.05 significance level was performed to compare primary care dimension means and total primary care scores. Linear regression models at 95% CI were used to assess associations between primary care dimension scores, patients’ characteristics and healthcare setting.ResultsThe final number of respondents was 962 representing 96.1% response rate. Patients in Neno hospitals scored 3.77 points higher than those in Thyolo health centres, and 2.87 higher than those in Blantyre health centres in total primary care performance. Primary care performance in health centres and in hospital clinics was similar in Neno (20.9 vs 19.0, p=0.608) while in Thyolo, it was higher at the hospital than at the health centres (19.9 vs 15.2, p<0.001). Urban and rural facilities showed a similar pattern of performance.ConclusionThese results showed considerable variation in experiences among primary care users in the public health facilities in Malawi. Factors such as funding, policy and clinic-level interventions influence patients’ reports of primary care performance. These factors should be further examined in longitudinal and experimental settings.

scholarly journals Assessing the quality of care for children attending health facilities: a systematic review of assessment tools

2021 ◽  
Vol 6 (10) ◽  
pp. e006804
Author(s):  
Alicia Quach ◽  
Shidan Tosif ◽  
Herfina Nababan ◽  
Trevor Duke ◽  
Stephen M Graham ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Psychosocial Support ◽  
Quality Measures ◽  
Quality Of Healthcare ◽  
Health Facilities ◽  
Assessment Tools ◽  
Experience Of Care ◽  
Care Assessment ◽  
Who Standards

IntroductionAssessing quality of healthcare is integral in determining progress towards equitable health outcomes worldwide. Using the WHO ‘Standards for improving quality of care for children and young adolescents in health facilities’ as a reference standard, we aimed to evaluate existing tools that assess quality of care for children.MethodsWe undertook a systematic literature review of publications/reports between 2008 and 2020 that reported use of quality of care assessment tools for children (<15 years) in health facilities. Identified tools were reviewed against the 40 quality statements and 510 quality measures from the WHO Standards to determine the extent each tool was consistent with the WHO Standards. The protocol was registered in PROSPERO ID: CRD42020175652.ResultsNine assessment tools met inclusion criteria. Two hospital care tools developed by WHO-Europe and WHO-South-East Asia Offices had the most consistency with the WHO Standards, assessing 291 (57·1%) and 208 (40·8%) of the 510 quality measures, respectively. Remaining tools included between 33 (6·5%) and 206 (40·4%) of the 510 quality measures. The WHO-Europe tool was the only tool to assess all 40 quality statements. The most common quality measures absent were related to experience of care, particularly provision of educational, emotional and psychosocial support to children and families, and fulfilment of children’s rights during care.ConclusionQuality of care assessment tools for children in health facilities are missing some key elements highlighted by the WHO Standards. The WHO Standards are, however, extensive and applying all the quality measures in every setting may not be feasible. A consensus of key indicators to monitor the WHO Standards is required. Existing tools could be modified to include priority indicators to strengthen progress reporting towards delivering quality health services for children. In doing so, a balance between comprehensiveness and practical utility is needed.PROSPERO registration numberCRD42020175652.

Evaluation of New York State's Child Health Plus: Children Who Have Asthma

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_E1) ◽  
pp. 719-727 ◽  
Author(s):  
Peter G. Szilagyi ◽  
Jane L. Holl ◽  
Lance E. Rodewald ◽  
Lorrie Yoos ◽  
Jack Zwanziger ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Quality Of Care ◽  
Health Insurance ◽  
Acute Asthma ◽  
Insurance Coverage ◽  
Asthma Severity ◽  
Asthma Care ◽  
Uninsured Children

Background. Little is known about the impact of providing health insurance to uninsured children who have asthma or other chronic diseases. Objectives. To evaluate the association between health insurance and the utilization of health care and the quality of care among children who have asthma. Design. Before-and-during study of children for a 1-year period before and a 1-year period immediately after enrollment in a state-funded health insurance plan. Intervention. In 1991 New York State implemented Child Health Plus (CHPlus), a health insurance program providing ambulatory and ED (ED), but not hospitalization coverage for children 0 to 12.99 years old whose family incomes were below 222% of the federal poverty level and who were not enrolled in Medicaid. Subjects. A total of 187 children (2–12.99 years old) who had asthma and enrolled in CHPlus between November 1, 1991 and August 1, 1993. Main Outcome Measures. Rates of primary care visits (preventive, acute, asthma-specific), ED visits, hospitalizations, number of specialists seen, and quality of care measures (parent reports of the effect of CHPlus on quality of asthma care, and rates of recommended asthma therapies). The effect of CHPlus was assessed by comparing outcome measures for each child for the year before versus the year after CHPlus enrollment, controlling for age, insurance coverage before CHPlus, and asthma severity. Data Ascertainment. Parent telephone interviews and medical chart reviews at primary care offices, EDs, and public health clinics. Main Results. Visit rates to primary care providers were significantly higher during CHPlus compared with before CHPlus for chronic illness care (.995 visits before CHPlus vs 1.34 visits per year during CHPlus), follow-up visits (.86 visits vs 1.32 visits per year), total visits (5.69 visits vs 7.11 visits per year), and for acute asthma exacerbations (.61 visits vs 0.84 visits per year). There were no significant associations between CHPlus coverage and ED visits or hospitalizations, although specialty utilization increased (30% vs 40%; P = .02). According to parents, CHPlus reduced asthma severity for 55% of children (no change in severity for 44% and worsening severity for 1%). Similarly, CHPlus was reported to have improved overall health status for 45% of children (no change in 53% and worse in 1%), primarily attributable to coverage for office visits and asthma medications. CHPlus was associated with more asthma tune-up visits (48% before CHPlus vs 63% during CHPlus). There was no statistically significant effect of CHPlus on several other quality of care measures such as follow-up after acute exacerbations, receipt of influenza vaccination, or use of bronchodilators or antiinflammatory medications. Conclusions. Health insurance for uninsured children who have asthma helped overcome financial barriers that prevented children from receiving care for acute asthma exacerbations and for chronic asthma care. Health insurance was associated with increased utilization of primary care for asthma and improved parent perception of quality of care and asthma severity, but not with some quality indicators. Although more intensive interventions beyond health insurance are needed to optimize quality of asthma care, health insurance coverage substantially improves the health care for children who have asthma.

scholarly journals Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021317 ◽  
Author(s):  
Lina Li ◽  
Chenwen Zhong ◽  
Jie Mei ◽  
Yuan Liang ◽  
Li Li ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Practice ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
First Contact

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.

scholarly journals Development and validation of the Vietnamese Primary Care Assessment Tool – provider version

2019 ◽  
Vol 20 ◽  
Author(s):  
Nguyen Thi Hoa ◽  
Anselme Derese ◽  
Jeffrey F. Markuns ◽  
Nguyen Minha Tam ◽  
Wim Peersman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Internal Consistency ◽  
Assessment Tool ◽  
Care Quality ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
The Impact ◽  
Primary Care Assessment Tool

Abstract Aim: To adapt the provider version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Background: There is a growing need to measure and explore the impact of various characteristics of health care systems on the quality of primary care. It would provide the best evidence for policy makers if these evaluations come from both the demand and supply sides of the health care sector. Comparatively more researchers have studied primary care quality from the consumer perspective than from the provider’s perspective. This study aims at the latter. Method: Our study translated and adapted the PCAT provider version (PCAT PE) into a Vietnamese version, after which a cross-sectional survey was conducted to examine the feasibility, internal consistency and validity of the Vietnamese PCAT provider version (VN PCAT PE). All general doctors working at 152 commune health centres in Thua Thien Hue province had been selected to participate in the survey. Findings: The VN PCAT PE is an instrument for evaluation of primary care in Vietnam with 116 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. From the translation and cultural adaptation stage, two items were combined, two items were removed and one item was added. Six other items were excluded due to problems in item-total correlations. All items have a low non-response or ‘don’t know/don’t remember’ response rate, and there were no floor or ceiling effects. All scales had a Cronbach’s alpha above 0.80, except for the Coordination scale, which still was above the minimum level of 0.70. Conclusion: The VN PCAT PE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the provider perspective.

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