A Causal Model for Physician Utilization: Analysis of Norwegian Data

Andersen, A. Skytt; Laake, Petter

doi:10.1097/00005650-198303000-00002

Cited by 35 publications

(20 citation statements)

References 7 publications

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“…The system is relatively uniform, and there is presumed to be no influence of financial barriers to the use of services. A multivariate analysis performed on a set of national data collected in 1973-74 showed that factors other than those introduced as need indicators were of minor importance in explaining variation in the use of general practitioners during one year (Andersen and Laake 1983). This finding has been supported by local studies (Grimsmo 1984;Elstad 1987).…”

Section: Sociology Of Health a Iuness Vol 14 No 2 1992 Issn 0141-9889mentioning

confidence: 85%

“…Although the evidence seems to support Titmuss's argument that 'higher income groups know how to make better use of the Service; they tend to receive more specialist attention;...', The Black Working Group found it difficult to interpret the existing data on GP visits and hospital in-patient and out-patient attendance, notably due to the problem of relating utilisation to need (Townsend and Davidson 1982, 206). Norwegian studies trying to take differential need into account have not revealed any social inequalities in GP visits (Andersen and Laake 1983;Grimsmo 1984;Elstad 1987). Andersen and Laake (1985), however, reported a positive effect of higher social status on both GP visits and use of specialist services.…”

Section: Discussionmentioning

confidence: 99%

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The Tromsø study: factors affecting patient‐initiated and provider‐initiated use of health care services

Fýlkesnes

Johnsen

Førde

1992

Sociology Health & Illness

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Knut Fylkesnes, Roar Johnsen and Olav Helge F0rde The Troms0 study: factors affecting patientinitiated and provider-initiated use of health care services Abstract The aim of this study was to examine factors influencing decisions involved in i) patient-intiated visits to general practitioners and ii) provider-initiated use of referral services.The analyses were performed with regression models on a set of data from a comprehensive population study of 7369 men aged 20-61 and 6832 women aged 20-56. Marked gender differences appeared in both patient-initiated and physician-initiated health care use. Various health status dimensions were found to be important determinants of patient-initiated use, in particular self-rated health, physical distress and transitory morbidities. Further, having a primary provider was found to increase patient-initated use strongly. Among the health status measures only self-rated health and chronic disease appeared as important determinants of provider-initiated use. Age and years of education were negatively associated with GP visits and positively associated with the use of referral services. The higher rate of referral of patients with higher educational achievement indicates a social status bias among general practitioners, creating considerably inequitable access to referral services. Further, the analyses indicate that positive lifestyles are associated with increased health care consumption among men.

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Section: Sociology Of Health a Iuness Vol 14 No 2 1992 Issn 0141-9889mentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

The Tromsø study: factors affecting patient‐initiated and provider‐initiated use of health care services

Fýlkesnes

Johnsen

Førde

1992

Sociology Health & Illness

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“…Numerous publications have stressed the importance of 'need' as a factor affecting medical service utilization. 10,11 The frequency of children's illnesses and parents' perception of their children's health status were indices used to evaluate the need component. Perceived health status is a highly subjective index, while the utilization of out-patients service is a self-determined health service.…”

Section: Discussionmentioning

confidence: 99%

Differences in physician utilization between Aboriginal and non-Aboriginal children

Tsu-Nai²,

Hsieh³

et al. 2000

Family Practice

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Objective. In the present study, we examined the factors affecting Aboriginal children's visits to a medical practitioner and compared them with non-Aboriginal children.Methods. We selected five Aboriginal communities and four neighbouring non-Aboriginal communities, and conducted a door-to-door survey, covering all children born after 1983. Of an initial sample of 1013 children, 896 (response rate 89.92% for non-Aboriginal children and 85.87% for Aboriginal children) completed the questionnaire for analysis.Results. In all, 896 children of non-mixed lineage with an age range of 0-12 years were collected into the study, including 316 Aborigines and 580 non-Aborigines. A higher percentage of non-Aboriginal children had more national health insurance coverage than Aboriginal children. The ratio of parents using the services of an out of community medical practitioner when their children were sick was higher for Aboriginal parents than for non-Aborigines. Medical injection frequency was higher in Aboriginal children. Linear regression was used to examine the factors affecting the frequency of physician utilization in the preceding month. Conclusion.A lower national health insurance coverage rate, and a higher rate of intramuscular injections for Aboriginal children plus difficulties in access to medical resources due to travel time and travel distance are still major problems for the Aborigines.

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“…Long travelling distance might seem a plausible explanation. However, two separate Norwegian studies indicate that travelling distance has very little influence on propensity to consult a doctor (Andersen and Laake 1983;Grimsmo 1984). It seems more likely that the morbidity of farmers and fishermen may be overestimated in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that this seems to be the case in primary health care (Andersen and Laake 1983;Grimsmo 1984;Elstad 1987). Low status groups have relatively poor health and a relatively high number of consultations with general practitioners.…”

Section: Background Datamentioning

confidence: 98%