scholarly journals A Geographical Study of Health Services Utilization among the Elderly in Hong Kong: From Spatial Variations to Health Care Implications

2009 ◽  
Vol 2 ◽  
pp. HSI.S3087 ◽  
Author(s):  
M. Wong ◽  
P.H. Chau ◽  
W. Goggins ◽  
J. Woo

Introduction Levels of utilization of health services vary socially and geographically. Differences in the rates of usage are also associated with geographical aspects of health care systems. The purpose of this study was to capture spatial variations in hospital health services utilization in the elderly population in Hong Kong, a Special Administrative Region of China. Materials and Methods We carried out a secondary analysis of a database from the Hospital Authority (HA) which covers 98% (N = 243,245) of the total registered deaths in Hong Kong during 1999 to 2005. Deaths at age 65y and above (N = 184,671) were included in the analysis. Age-sex weighted mean utilization ratio of hospital services was calculated by dividing the age-sex weighted mean usage of a particular service for each district by that for the whole territory. The variation in utilization by the seniors was analyzed in terms of four types of services: length of stay (LOS) in HA hospitals, number of inpatient admissions, number of visits to specialist outpatient department (SOPD), and attendances at accident and emergency department (AED). Results Deaths at age 65y and above contributed to 76% of the total registered deaths. Each district contributed 1.0% to 9.1% of the total number of deaths in Hong Kong. Spatial analysis of the age-sex weighted mean utilization ratio showed significant geographic variation in the use of hospital services: the range of difference in the LOS between the lowest and highest district was 44%, while some differences as high as 33%, 35% and 39% in utilization ratios were observed in relation to number of inpatient admissions, visits to SOPD, and attendances at AED respectively. However, the patterns of these variations were not consistent for the four types of service being analyzed. Conclusions Geographic variation in the utilization of hospital health services across the 18 districts in Hong Kong among the elderly population during the last three years before death was demonstrated. However, the patterns of variation were different for the types of services being examined. Further studies using primary data at an individual level are needed to explain the variations. Detailed analysis examining the relationship between service provision, accessibility and health outcomes are also indicated in order to inform the planning of health service delivery.

Author(s):  
Thang Pham ◽  
Nguyen Nguyen ◽  
Sophie ChieuTo ◽  
Tuan Pham ◽  
Thanh Nguyen ◽  
...  

In Vietnam, as in much of the world, the elderly population is growing rapidly. Two-thirds of Vietnam’s elderly live in rural areas, where there may be unique health profiles and needs. Furthermore, the sex ratio in the elderly population is highly skewed. The relationship between sex, health-seeking behavior, and health outcomes in elderly individuals residing in rural areas has not been well-characterized, and needs to be elucidated in order to better serve this population. This study sought to explore the associations of sex with health and health-seeking behavior among the elderly in Soc Son, a rural district of Hanoi. A cross-sectional design was employed; elderly women and men were surveyed across the domains of socioeconomic information, health status, and healthcare service utilization. We found differences between women and men in sociodemographic characteristics, quality of life, health outcomes, and patterns of health services utilization. Overall, women had poorer health and quality of life, but no difference was found between sexes regarding level of health services utilization. Future research should expand upon these findings and, moreover, characterize their underlying systemic, sociocultural, and psychological mechanisms, in order to help bring solutions to improve the health of elderly persons in rural parts of Vietnam.


2012 ◽  
Vol 10 (1) ◽  
pp. 24-29 ◽  
Author(s):  
S Sanjel ◽  
N Mudbhari ◽  
A Risal ◽  
K Khanal

Background Population ageing is a common problem faced in many countries world-wide. Due to physiological and biochemical changes in the elderly, increased incidence of diseases is observed. There is often low use of health services by the elderly for a variety of reasons. Objective To examine the status of health care utilization and to determine the factors associated with utilization of health care among the elderly population of Dhulikhel Municipality. Methods A quantitative descriptive-cross sectional study, with a total number of 200 elderly people residing in Dhulikhel Municipality, was selected for the study. Data were collected across the months of June - July 2011 applying two-staged cluster and systematic random sampling method. Both descriptive and inferential statistics were measured. Results Sixty eight percent of the elderly visited medical personnel in the past year. Eight percent of them visited the emergency department where most of them reported with symptoms attributed to heart disease. Among 200 elderly, 12.5% of them were admitted to the hospital and 53.0% utilized diagnostic services. Age, marital status, activities of daily living, and regular medication showed significant association with health services utilization at 95% level of confidence (p >0.05). Conclusion Marital status, daily living habits, existence of chronic disease, and regular medication demonstrated significant association with the utilization of health care. Social support services, informal education, and awareness programs targeting the senior citizens and studies covering a diverse population are recommended. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 34-39 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6911


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bakhtiar Piroozi ◽  
Farman Zahir Abdullah ◽  
Amjad Mohamadi-Bolbanabad ◽  
Hossein Safari ◽  
Mohammad Amerzadeh ◽  
...  

Purpose The purpose of this study is to investigate the status of perceived need, seeking behavior and utilization of health services in the elderly population of Sanandaj (west of Iran). Design/methodology/approach This is a cross-sectional study conducted on 800 elderly people in Sanandaj. Subjects were selected using multistage sampling and data were collected using self-report questionnaires. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with seeking perceived need. Also, the concentration index was used to measure the inequality in using health services. Findings The perceived need for outpatient (during the last 30 days) and inpatient health-care services (during the past 12 months) was 69.7% and 29.7%, respectively. Among them, the unmet need for outpatient and inpatient health-care services was 46.6% and 17%, respectively. Having health insurance (adjusted OR 12.08; 95% confidence interval [CI] 1.04–140.11), middle economic status (adjusted OR 5.18; 95% CI 1.30–20.51) and being in an age group of 65–70 years (adjusted OR 7.60; CI 1.42–40.61) increased the chance of seeking inpatient care. Also, being in an age group of 60–65 years (adjusted OR 0.41; 95% CI 0.18–0.95) reduced the chance of seeking outpatient care. There was also a pro-rich inequality in using outpatient health services. Originality/value The elderly population suffers from unmet health-care needs, especially in outpatient services. The most important reason for not seeking outpatient and inpatient services was financial barriers and self-medication, respectively. So, designing targeted policies and interventions to address barriers in the conversion of need to demand in the elderly population is essential.


1997 ◽  
Vol 352 (1363) ◽  
pp. 1887-1893 ◽  
Author(s):  
John Grimley Evans

Health services for older people in the NHS have developed pragmatically, and reflect the nature of disease in later life and the need to agree objectives of care with patients. Although services are likely to be able to cope with the immediate future, the growth of the elderly population anticipated from 2030 calls for long–term planning and research. The issue of funding requires immediate political thought and action. Scientifically the focus needs to be on maximizing the efficiency of services by health services research and reducing the incidence of disability in later life through research on its biological and social determinants. Senescence is a progressive loss of adaptability due to an interaction between intrinsic (genetic) processes with extrinsic factors in environment and lifestyle. There are grounds for postulating that a policy of postponement of the onset of disability, by modifications of lifestyle and environment, could reduce the average duration of disability before death. The new political structures of Europe offer underexploited–unexploited opportunities for the necessary research.


1987 ◽  
Vol 3 (2) ◽  
pp. 275-280
Author(s):  
Mark G. Field

AbstractThe classical equation for the production of goods and services, that is, the combination of labor, capital, and knowledge, constrained by the time dimension, may also be used to examine the production of medical and hospital services. However, this is qualified by the special nature of the “capital” used in health care, particularly medical technology. Because of the particular nature of health services, the adoption and the use of technology follows rules that are different from those in the industrial sphere. These differences are examined in some detail as are the implications for the health field in general, and for the hospitals where most of the new (and often costly) technology is located.


2021 ◽  
Vol 3 ◽  
Author(s):  
Katinka Linnamäki

The purpose of this paper is to examine the Hungarian Fidesz-KDNP government´s discursive practices of control and care during the first wave of the COVID-19 pandemic. The paper researches the Hungarian government’s communication on the official Hungarian COVID-19 Facebook page during the first wave of the pandemic. Its aim is to answer the question how the Hungarian government articulated control and care to reinforce sedimented gendered division of care work and institutions of control to tackle the potential disruption of the system of care before the widespread vaccination of the elderly population was available in the country. The paper argues that the pandemic has allowed the government to exert control in areas, such as the crisis in the workforce market and health care system, as well as in the destabilized system of care work. The main finding is that in the material the government performs control over care work, whose intensified discussion during the pandemic could lead to a potential disruption within the illiberal logic on two different levels. First, physical care work related to immediate physical needs, like hunger, clothing, pain enacted by female shoppers, female health care workers and female social workers, is newly defined during the pandemic as local, family-bound and a naturally female task. Second, the government articulates care work, either as potentially harmful (for the elderly population and thus indirectly to the government’s familialist politics), or as vulnerable and in need of protection from outside influences (portrayed through the interaction of health care workers and “hospital commanders”). This enables the government to perform full state control over care workers through the mobilization of police and military masculinity and to strengthen and re-naturalize the already existing hierarchies between traditional gender roles from a new perspective during the pandemic. This state of affairs highlights the vulnerability both of the elderly population, on whom its familialism builds, and of the system of informal care work, which builds on the unpaid care work of female citizens, who paradoxically are also articulated as potential harm for the elderly and for the system.


2011 ◽  
Vol 4 (2) ◽  
pp. 80-91
Author(s):  
Ana Lledó Boyer ◽  
Mª Ángeles Pastor Mira ◽  
Sofía López-Roig ◽  
Maximiliano Nieto Ferrandéz

Studies on the socioeconomic impact of fibromyalgia (FM) have shown the high health services use done by these patients. These data indicate the challenge of dealing with these people, their treatment and rehabilitation, as well as the need of changes in actions and implementation of cost-effective approaches. In this study we reviewed the literature on the health care use behavior in FM. The data shows that the emotional state and catastrophizing are relevant factors in the onset of seeking health care, and within the system, higher self-efficacy, attributions of symptoms to external factors, the perception of good health and lower comorbidity is associated with less use.


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