A sequential model for the structure of health care utilization

Herrmann, Wolfram; Haarmann, Alexander; Bærheim, Anders

doi:10.1371/journal.pone.0176657

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…The “need” factors mainly focus on the evaluated or perceived health condition that requires care [33]. The use of services is generally measured in terms of use or not use, frequency of use and cost of health-care services [35, 36].…”

Section: Introductionmentioning

confidence: 99%

What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand

et al. 2019

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Background ‘Yaa Chud’ is a non-prescribed poly-pharmaceutical pack containing several types of drugs, including antibiotics and steroids, which can be purchased over the counter in Thailand for self-medication. Although it is illegal, it is still available at some community outlets. This study aimed to understand access to and use of Yaa Chud at the community level in order to raise awareness on its usage and to provide policy recommendations to address the problem. Methods This study employed qualitative methods, including in-depth interviews with 18 drug suppliers and 16 community members, and six focus group discussions. It included inventories from 17 drug suppliers. Data were collected in selected communities of the Kanchanaburi Demographic Surveillance System, located in the western region of Thailand.Thematic analysis was based upon the Health Services Utilization Model and conducted using the Open Code qualitative software program. Results Overcrowding, long waiting times, and a perceived unwelcoming environment at public health-care service outlets were identified as factors that drive people into the private sector, where loose regulation of drug laws facilitates access and use of Yaa Chud. Migrants and older people were most likely to seek and use Yaa Chud, especially for mild illness. Availability, easy access through a user’s network, low cost, and perceived effectiveness were identified as factors that enable access and use of Yaa Chud. Conclusions Though illegal in Thailand, Yaa Chud is likely to remain available for self-medication by community members, due to the persisting demand by the elderly and migrant workers. There is an urgent need to replace these mixed medications with better choices. Safer Yaa Chud may be a preferred, first-line health-care option, which could help reduce congestion in the formal health-care setting. At the same time, enforcement of regulatory compliance needs to be continued in order to stop the supply of unsafe Yaa Chud. Electronic supplementary material The online version of this article (10.1186/s12889-019-7300-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand

et al. 2019

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“…The use of health services is a complex behavioral phenomenon that is affected by multiple factors including availability, distance, cost, and quality of services, as well as attitudes, cultural beliefs, socioeconomic characteristics, and individuals’ self-perception of health [ 1 , 2 , 3 ]. In recent decades, there has been an increase in the demand and use of health services due to cardiovascular risk factors and metabolic syndrome, particularly in low- and middle-income countries, due to the physical and progressive deterioration, disability, and high comorbidities and mortality [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Association between the Use of Health Services, Cardiovascular Risk Factors and Metabolic Syndrome in Mexican Adults

Ortiz-Rodríguez

Aldaz-Rodríguez

González-Robledo

et al. 2021

IJERPH

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Background: The use of health services is a complex behavioral phenomenon affected by multiple factors (availability, distance, cost, quality, attitudes, cultural beliefs, socioeconomic characteristics, and individuals’ self-perception of health). Mexico has a segmented health system, and the access to it depends on the labor insertion and the population’s ability to pay. Objective: To assess association between use of health services and cardiovascular and metabolic syndrome risk factors among Mexican adults. Methods: Analytical cross-sectional nationally representative study carried out on Mexican adults (≥20-year-old adults of both sexes; n = 4595). Socioeconomic factors, geographic area, health care coverage, information about the use of health services, previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, triglyceride, total cholesterol, HDL-cholesterol, and glucose plasma levels were measured. Metabolic syndrome (MetS) and cardiovascular risk factors were assessed. Prevalences were expressed in terms of percentages, and significant differences were calculated using χ2 test. Univariate and multivariate analysis was performed to evaluate the association between the use of health services and cardiovascular risk factors and sociodemographic variables. Results: The probability of using health services is higher and more significant in subjects with obesity, diabetes (OR (95% CI): 1.73 (1.49–2.00; p < 0.001), hypertension (OR (95% CI): 1.29 (1.14–1.45; p < 0.001), hypertriglyceridemia (OR (95% CI): 1.30 (1.15–1.46; p < 0.001), and in those with hypercholesterolemia (OR (95% CI): 1.23 (1.03–1.39; p = 0.001). Conclusions: Among health service users, there is a positive significant association between the use of health services and the presence of metabolic syndrome, obesity, diabetes, hypertension, hypertriglyceridemia, and hypercholesterolemia.

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“…Previous studies have emphasized the importance of describing and understanding health care utilization and health care systems in health care planning W. J. Hermann, A. Haarmann, and Baerheim (2017); Sofianopoulou, Rushton, Rubin, and Pless-Mulloli, (2012). Many researchers have discussed the inequality of access and utilization regarding differences in sociodemographic factors or even locations (Terraneo, 2015).The demand for empirical data for health care planning is high, as the health care system in the KSA is progressively changing.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Access, Utilization, and Level of Satisfaction With Primary Health Care Services in Hafar Al-batain City of Saudi Arabia

Alharbi¹,

Alzghool²

2019

GJHS

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BACKGROUND: Primary Health Care (PHC) Services in Saudi Arabia has reportedly been poorly accessed and utilized. Another concern is that the kingdom has to be strategic in reducing inequalities that exist between rural and urban communities. At present, there were limited scientific studies on access, utilization, and satisfaction of PHC services in areas most central to the kingdom. AIM: The aim of this study is to explore the factors associated with access, utilization, and level of satisfaction with primary health care services in Hafar Al-batain of Saudi Arabia. METHOD: A survey was conducted on June to August 2018 and data were gathered from June to August 2018. A self-report questionnaire was used which asked for the participants’ characteristics, organization factors, financial factors, doctor-patient communication, access, utilization, satisfaction to PHC services and barriers were distributed to the different health centers. A total of 384 PHC receivers served as respondents of the study. Data analysis were processed and Chi-square was used to analyse quantitative data using Statistical Package for Social Sciences Ver. 21. Thematic analysis was used in analysing qualitative data.   RESULTS: Findings showed that 50% of the total respondents were satisfied to some extent with the PHC services. On the other hand, only 39.7% were completely satisfied. Organizational, financial and doctor-patient communication factors were found to be barriers to PHC services in terms of access and utilization. Gender, age and educational level were found to influence perceived satisfaction towards PHC services. Themes relevant to barriers to PHC services were relevant to inadequate facilities and services, inaccessible location and access of health services, lack of specialized health care workers and services, poor observance of therapies and management, and insufficient implementation of policy and protocols. CONCLUSION: Health care services in Hafar Al-batin were found satisfying to some extent but were found to have areas which needs improvement which are relevant to factors in the organizational, finance, doctor patient communication and health promotion and prevention.

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A sequential model for the structure of health care utilization

Cited by 8 publications

References 25 publications

What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand

What is in the drug packet?: access and use of non-prescribed poly-pharmaceutical packs (Yaa Chud) in the community in Thailand

Association between the Use of Health Services, Cardiovascular Risk Factors and Metabolic Syndrome in Mexican Adults

Factors Associated With Access, Utilization, and Level of Satisfaction With Primary Health Care Services in Hafar Al-batain City of Saudi Arabia

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