A Behavioral Model of Families' Use of Health Services

Kehrer, Barbara H.; Andersen, Ronald; Glaser, William A.

doi:10.2307/145064

Cited by 27 publications

(23 citation statements)

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“…Andersen health service utilization model or behavioral model, developed in 1968, is applied internationally to research the influencing factors of health service utilization [ 14 ]. In accordance with it, independent variables were classified into three categories: (1) predisposing variables, (2) enabling variables, and (3) need variables.…”

Section: Methodsmentioning

confidence: 99%

Influencing factors of inequity in health services utilization among the elderly in China

Sun

et al. 2018

Int J Equity Health

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BackgroundWith the rise of the aging population, it is particularly important for health services to be used fairly and reasonably in the elderly. This study aimed to assess the present inequality and horizontal inequity for health service use among the elderly in China and to identify the main determinants associated with the disparity.MethodsThis cross-sectional study was based on the sample of the survey of the China Health and Retirement Longitudinal Study (CHARLS) for 2015. The elderly was defined as individuals aged 60 and above, with a total of 7836 participants. We used the concentration index (CI) and the horizontal inequity (HI) to measure the inequity of the utilization of health services. The method of concentration index decomposition was utilized to measure the contribution of various influential factors to the overall unfairness.ResultsThe CI for the probability and the frequency of outpatient use were 0.1102 and 0.1015, respectively, and the corresponding values of inpatient use were 0.2777 and 0.2980, respectively. The household consumption expenditure disparity was the greatest inequality factor favoring the better-off. The Urban Employee Basic Medical Insurance made a pro-wealth contribution to inequality in frequency of health services utilization (17.58% for outpatient and 13.40% for inpatient). The contributions of New Rural Cooperative Medical Scheme on reducing unfairness in inpatient use were limited (− 2.23% for probability of inpatient use and − 5.89% for frequency of inpatient use).ConclusionsThere was a strong pro-rich inequality in both the probability and the frequency of use for health services among the elderly in China. The medical insurance was not enough to address this inequity, and different medical insurance schemes had different effects on the unfairness of health service utilization.Electronic supplementary materialThe online version of this article (10.1186/s12939-018-0861-6) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Influencing factors of inequity in health services utilization among the elderly in China

Sun

et al. 2018

Int J Equity Health

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“…The former's answer was "yes" or "no", while the latter's answer was "0, 1, 2, 3, 4 or more." Independent variables were divided into three components (predisposing variables, enabling variables and need variables), in accordance with the Andersen's behavioral model [27]. Since its inception, the Andersen's model had been verified by a number of empirical studies and was widely considered to be the most appropriate model for analyzing the utilization of health services [28,29].…”

Section: Data and Variablementioning

confidence: 99%

“…The predisposing variables were the individual characteristics of people who tend to use inpatient services before the onset of the diseases [27,30,31], including gender (female, male), age (45~59, 60~74, 75+), education level (illiterate, primary school, middle school, high school and above), marital status (married, unmarried) and employment status (unemployed, agricultural work, working in units, other working).…”

Section: Data and Variablementioning

confidence: 99%

“…The enabling variables referred to an individual's ability to access inpatient services [27,30,31], including health insurance schemes (no health insurance, UEBMI, URBMI, NRCMS, other health insurance), geographic location (east, central, west), and residency location (urban, rural). The per capita household consumption expenditure (PCE), as an indicator to measure family economic level, was closely related to well-being and easy to calculate [15].…”

Section: Data and Variablementioning

confidence: 99%

“…The need variables represented the perceived needs and actual needs of the inpatient services utilizaiton [27,30,31], including self-assessed health status, disability, disability in physical activity of daily living (PADL) and disability in instrumental activity of daily living (IADL). Self-assessed health status was divided into "healthy" or "unhealthy", while disability, PADL and IADL were all categorized as "yes" or "no".…”

Section: Data and Variablementioning

confidence: 99%

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Inequity in inpatient services utilization: a longitudinal comparative analysis of middle-aged and elderly patients with the chronic non-communicable diseases in China

Wang

Sun

et al. 2020

Int J Equity Health

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Background: Aging and the chronic non-communicable diseases (NCDs) challenge the Chinese government in the process of providing hospitalization services fairly and reasonably. The Chinese government has developed the basic medical insurance system to solve the problem of "expensive medical cost and difficult medical services" for vulnerable groups and alleviate the unfair phenomenon. However, few studies have confirmed its effect through longitudinal comparison. This study aimed to explore the trend in the inequity of inpatient use among middleaged and elderly individuals with NCDs in China. Methods: This longitudinal comparative study was based on CHARLS data in 2011, 2013 and 2015. Concentration index (CI) was used to measure the variation trend of inequity of inpatient services utilization, while the decomposition method of the CI was applied to measure the factors contributing to inequity in inpatient services utilization. The effect of each factor on the change of inequity in inpatient services utilization was divided into the change of the elasticity and the change of inequality using the Oaxaca-type decomposition method. Results: The affluent middle-aged and elderly patients with NCDs used more inpatient services than poor groups. The per capita household consumption expenditure (PCE) and Urban Employee Basic Medical Insurance (UEBMI) contributed to the decline in pro-rich inequality of inpatient use, while the New Rural Cooperative Medical Scheme (NRCMS) contributed to the decline in pro-poor inequality of inpatient use. Conclusions: There was a certain degree of pro-rich unfairness in the probability and frequency of inpatient services utilization for middle-aged and elderly individuals with NCDs in China. The decrease of pro-wealth contribution of PCE and UEBMI offset the decrease of pro-poor contribution of NRCMS, and improved the equity of inpatient services utilization, favoring poor people.

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Paid sick leave and preventive health care service use among U.S. working adults

DeRigne

Stoddard-Dare

Collins

et al. 2017

Preventive Medicine

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A Behavioral Model of Families' Use of Health Services

Cited by 27 publications

References 0 publications

Influencing factors of inequity in health services utilization among the elderly in China

Influencing factors of inequity in health services utilization among the elderly in China

Inequity in inpatient services utilization: a longitudinal comparative analysis of middle-aged and elderly patients with the chronic non-communicable diseases in China

Paid sick leave and preventive health care service use among U.S. working adults

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