scholarly journals Understanding the Patterns and Processes of Primary Care Use: A Combined Quantitative and Qualitative Approach

1998 ◽  
Vol 3 (4) ◽  
pp. 1-13 ◽  
Author(s):  
Anne Rogers ◽  
Gerry Nicolaas
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Decision Making ◽  
Health Status ◽  
Self Care ◽  
Health Care Utilisation ◽  
Care Services ◽  
Care Utilisation ◽  
The Relationship ◽  
The Way

This paper addresses the combined use of quantitative and qualitative methodology to understand the relationship between need, demand and use of primary careservices. The study conducted in three different areas in the North west of England was designed to, link health status to subsequent use of health care in a waywhich might be used for service planning and the allocation of resources, and to provide data to inform a long term programme examining the relationship between need and demand for primary care. The study was in two stages, a survey and diary study designed to ascertain frequency of health care utilisation and health status of households, followed by a linked qualitative study consisting of in-depth interviews on a subset of people experiencing a range of common complaints seen in primary care. The mixture of methodologies gave a broader understanding of the dynamics of health utilisation in the localities studied. The survey and diary data showed the way in which key variables can be used to map the patterns of primary care utilisation in a population and the extent of self care actions and lay management of illness undertaken within households. We found that ill people are far more likely to use self care than professional health care services, and when they do use formal services, this tends to be in addition to self care practices. The qualitative data illuminated more about the processes of health care utilisation, particularly the way in which the past experience of illness and service contact coalesced with peoples’ more immediate decision making about using primary care services. The findings suggest that health care use is most appropriately viewed as an interplay between agency and structure rather than the outcome of ‘expressedneed’, individual decision making or ‘supply induced’ demand.

scholarly journals Health status and health care utilisation of patients in complementary and conventional primary care in Switzerland—an observational study

2005 ◽  
Vol 23 (1) ◽  
pp. 116-124 ◽  
Author(s):  
André Busato ◽  
Andreas Dönges ◽  
Sylvia Herren ◽  
Marcel Widmer ◽  
Florica Marian
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Observational Study ◽  
Health Care Utilisation ◽  
Care Utilisation

COMMON HEALTH PROBLEMS AND UTILIZATION OF PRIMARY HEALTH CARE SERVICES IN THE RURAL AREAS OF THUA THIEN HUE PROVINCE

2020 ◽  
pp. 62-71
Author(s):  
Tuan Duong Quang ◽  
Anh Le Ho Thi Quynh ◽  
Hung Nguyen Nam ◽  
Tam Nguyen Minh
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Status ◽  
Rural Areas ◽  
Health Problems ◽  
Care Utilization ◽  
Mountainous Area ◽  
Geography Information System ◽  
Care Services ◽  
Geography Information

Although health status in Vietnam has been much improved, people living in rural areas have faced several challenges, including a rapid increase of the aging population, inadequate capacity of health system, and problems of inequities in access to the healthcare system. Objectives: This study aimed to explore the common health problems and health care utilization of people living in the rural areas of Thua Thien Hue province. Methods: A cross-sectional study and geography information system application were carried out. A total of 2.631 individuals in 599 households of a lowland area and a mountainous area was interviewed with a structured questionnaire regarding to health status and health care utilization during the last 6 months. Geography information system software was used to visualize these data of household. Results: 32.8% of participants reported at least an episode of illness within 6 months prior to the interviews. Most of illness people lived in mountainous area. Fever, uncomplicated hypertension, cough, and headache were reported as the most common health problems among participants. Most of participants preferred to visit commune health centers and district hospitals. People in different areas have a significant difference trend from another in choosing health facilities. Conclusion: Residents in difficult-to-reach areas had high prevalence of health problems and experienced social and structural barriers of healthcare services access. It is necessary to improve the availability and quality of primary care services to improve the health status and accessibility of disadvantaged people. Keywords: primary care, utilization, rural areas, health care acessibility

Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

2001 ◽  
Vol 7 (1) ◽  
pp. 65 ◽  
Author(s):  
Hal Swerissen ◽  
Jenny Macmillan ◽  
Catuscia Biuso ◽  
Linda Tilgner
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Centres ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
The Relationship

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

FACTORS ASSOCIATED WITH THE ASSESSMENT ON HEALTH CARE QUALITY AT COMMUNE HEALTH CENTERS IN THUA THIEN HUE PROVINCE

2017 ◽  
pp. 53-61
Author(s):  
Minh Tam Nguyen ◽  
Thi Hoa Nguyen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Satisfaction ◽  
Health Status ◽  
Care Quality ◽  
Health Care Facilities ◽  
Health Centers ◽  
Important Indicator ◽  
Care Services ◽  
Primary Care Services

Background: Patient satisfaction is an important indicator of healthcare quality. Better satisfaction is associated with greater adherence to treatment and better health outcomes. Primary care is considered the basic structure of many healthcare systems. Evaluation of healthcare provision is essential in the ongoing assessment and consequent quality improvement of healthcare services. Objective: To describe and analyze the determinants associated with patient assessment and satisfaction in primary care. Methods: The survey was conducted with 519 households and 209 patients at 18 commune health centers. The questionnaire included sociodemographic variables, health status, and use and satisfaction with primary care services. We undertook descriptive analyses, bivariate correlations to study the relationship between levels of satisfaction and the explanatory variables for demographics, health status and health services for households and patients. Results: The majority of households and patients were satisfied with the health care services at primary health care facilities. Satisfaction of waiting time, communication and counseling by healthcare providers was high. We found significant associations between the level of satisfaction and owning health insurance card, the first contact point assigned at CHCs, the severity of illness episodes, and health condition of participants. Conclusions: The results provide evidence on factors that should be taken into account in the planning and development of health policies with respect to the quality and delivery of primary care services in order to enhancing the satisfaction of clients. Key words: consumer satisfaction, patient satisfaction, primary care, quality indicators

scholarly journals Depressive Symptoms, Lack of Physical Activity, and Their Combination Towards Health Care Utilisation Frequency

2019 ◽  
Vol 16 (23) ◽  
pp. 4697
Author(s):  
Sandra Haider ◽  
Igor Grabovac ◽  
Anita Rieder ◽  
Thomas Ernst Dorner
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Depressive Symptoms ◽  
Health Care Services ◽  
Health Care Utilisation ◽  
Related Factors ◽  
Men And Women ◽  
Care Services ◽  
Care Utilisation ◽  
Nationally Representative

Depressive symptoms and lack of physical activity are independent factors that lead to higher health care utilisation, often occurring simultaneously. We aimed to assess the effects of depressive symptoms, lack of aerobic physical activity (PA), and the combination of those factors on the probability of using in- and outpatient health care services in men and women. Data from 15,770 people from the nationally representative Austrian Health Interview Survey (AT-HIS) were used. In analysis, depressive symptoms, adjusted for sociodemographic, health related, and lifestyle-related factors were associated with higher odds of outpatient health care utilisation (OR: 1.60; 95% CI: 1.19–2.14) in men and (OR: 2.10; 95%CI: 1.65–2.66) in women, and with higher odds of inpatient health care utilisation (OR: 1.52; 95% CI: 1.09–2.10) in men and (OR: 2.09; 95% CI: 1.64–2.68) in women. However, depressive symptoms were not associated with higher health care utilisation in the fully adjusted models. In men, co-existence of depressive symptoms and lack of health enhancing physical activity (HEPA) was associated with higher odds of using inpatient health care services, compared to the presence of only one or none of the factors. In conclusion, our results show that depressive symptoms are associated with more health care utilisation in both men and women and that the co-existence of both depressive symptoms and lack of HEPA elevated the odds for inpatient health care utilisation in men even more.

scholarly journals Effect of informal care on health care utilisation for the elderly in China: Evidence from China Health and Retirement Longitudinal Study (CHARLS)

2021 ◽  
Author(s):  
Xinlan Chen ◽  
Dai Su ◽  
Xinlin Chen ◽  
Yingchun Chen
Keyword(s):  
Health Care ◽  
Longitudinal Study ◽  
Panel Data ◽  
Informal Care ◽  
The Elderly ◽  
Health Care Utilisation ◽  
Negative Binomial Regression Model ◽  
Service Utilisation ◽  
Care Utilisation ◽  
The Relationship

Abstract BackgroundReceiving informal care from family members is the mainstream way of care for the elderly in China because of the influence of the culture of filial piety. However, the relationship between informal care and health care use in urban and rural areas needs to be further explored. This study aimed to understand the effect of informal care on health care utilisation for the elderly and explore how this effect differ between urban and rural China.MethodA total of 5704 residents aged 65 years and above were selected from the wave 3 (2015) and wave 4 (2018) of the China Health and Retirement Longitudinal Study, which is a nationally representative survey. A negative binomial regression model for panel data was used to explore the relationship between informal care and health care utilisation. Besides, a fixed-effect binary choice model for panel data was used for sensitivity test.ResultThe elderly who received informal care had an increase in outpatient and inpatient visits compared with those who did not receive. The inpatient visits of the elderly who received 15–29 days of informal care was higher (incidence rate ratio [IRR] = 2.082, P < 0.05). In addition, the elderly who received informal care for more than 30 days had 39.6% more inpatient visits (IRR = 1.396, P < 0.01) and 37.4% more outpatient visits than the elderly who did not receive informal care (IRR = 1.374, P < 0.05). For urban respondents, receiving informal care can facilitate outpatient use of the elderly, but for rural respondents, receiving informal care can predict an increase in outpatient and inpatient visits.ConclusionThe impact of informal care on health care utilisation varies between rural and urban residents. Relevant departments should pay attention to the differences in the medical service utilisation amongst different elderly groups and gradually reduce the medical inequality of the elderly.

scholarly journals In adults with multimorbidity, does the provision of social care services have an effect on the use of primary care and secondary care health services?

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
David Henderson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Secondary Care ◽  
Social Care ◽  
Grey Literature ◽  
Qualitative Synthesis ◽  
Delivery Of Care ◽  
Care Services ◽  
Health And Social Care ◽  
The Relationship

ABSTRACT ObjectivesHealth and social care is an area of high policy importance in the UK. Integration of health boards with local authority provided social care in Scotland in 2016 is a major structural change in delivery of care. Improvements in service and efficiency are expected and indeed required in an era of declining budgets.  Intuitively, health and social care are closely linked, particularly for those with multiple morbidities. However, little is known about the relationship between health and social care services and how usage of one has an impact on the other in terms of outcomes and costs. The study aims to describe the methods that have been used to analyse the relationship between social care, primary care and secondary care services. Findings will inform the analysis of a large linked dataset of health care, social care and benefits data that will investigate the interactions between health and social care, multimorbidity and socioeconomic status. ApproachA Scoping review of literature aiming to identify academic studies that have made an assessment of the relationship between health care and social care. A search of academic databases will be augmented by a search of grey literature aiming to identify the extent, range and nature of studies. Data will be extracted on populations, study designs, results and recommendations. Results will be visualised in charts alongside a descriptive qualitative synthesis. ResultsExpected June 2016

scholarly journals A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

2020 ◽  
Author(s):  
Tom Pierse ◽  
Luke Barry ◽  
Liam Glynn ◽  
Andrew Murphy ◽  
Sharon Cruise ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Northern Ireland ◽  
Health Care Utilisation ◽  
Type I ◽  
Data Set ◽  
Care Programme ◽  
Republic Of Ireland ◽  
Care Utilisation ◽  
The Republic

Abstract Background Primary care policies for diabetes have differed between Northern Ireland (NI) and the Republic of Ireland (ROI). In NI, the Quality and Outcomes Framework (QOF) system was adopted in 2004. In ROI, prior to the Cycle of Care programme being established in 2015 specific financial support for GPs providing diabetic primary care was not available. The aims of this study are to compare health and healthcare utilisation among people with diabetes in the NI and ROI.Methods Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA) and the Republic of Ireland (TILDA) are used to compare people with diabetes (Type I and Type II) in the two jurisdictions. The combined data set comprises 1,536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics.Results The overall prevalence in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). The diabetic population in NI also appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A&E utilisation.Conclusion There are a range of factors that influence the quality of primary care for people with diabetes. While the QOF system in Northern Ireland is likely to have improved some aspects of care by providing financial incentives for identification and management, unless accompanied by improved access to care their ability to impact on outcomes may be compromised.

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