Factors associated with using alternative sources of primary care: a cross-sectional study

Abstract

BackgroundMobile (MHCs), Community (CHCs), and School-based health clinics (SBHCs) are understudied alternative sources of health care delivery used to provide more accessible primary care to disenfranchised populations. However, providing access does not guarantee utilization. This study explored the utilization of these alternative sources of health care and assessed factors associated with residential segregation that may influence their utilization.MethodsA cross-sectional study design assessed the associations between travel distance, perceived quality of care, satisfaction-adjusted distance (SAD) and patient utilization of alternative health care clinics. Adults (n = 165), child caregivers (n = 124), and adult caregivers (n = 7) residing in New Orleans, Louisiana between 2014 and 2015 were conveniently sampled. Data were obtained via face-to face interviews using standardized questionnaires and geospatial data geocoded using GIS mapping tools. Multivariate regression models were used to predict alternative care utilization.ResultsOverall 49.4% of respondents reported ever using a MCH, CHC, or SBHC. Travel distance was not significantly associated with using either MCH, CHC, or SBHC (OR = 0.91, 0.74–1.11 p > .05). Controlling for covariates, higher perceived quality of care (OR = 1.02, 1.01–1.04 p < .01) and lower SAD (OR = 0.81, 0.73–0.91 p < .01) were significantly associated with utilization.ConclusionsProvision of primary care via alternative health clinics may overcome some barriers to care but have yet to be fully integrated as regular sources of care. Perceived quality and mixed-methods measures are useful indicators of access to care. Future health delivery research is needed to understand the multiple mechanisms by which residential segregation influences health-seeking behavior.

Mudanças no padrão de utilização de serviços de saúde no Brasil entre 2013 e 2019

“…Todavia, de 2013 a 2019, houve um crescimento significativo no uso das UPA como fonte usual cuidado, mostrando que a ex-pansão do acesso foi relevante para a obtenção da assistência, mas nem sempre é adequada se não responder, inteiramente, às necessidades do usuário 30 . Estudo realizado nos Estados Unidos mostra que a prestação de cuidados primários através de serviços alternativos pode superar algumas barreiras de acesso, porém a falta de integração na rede de serviços pode implicar na insatisfação dos usuários sobre a qualidade do serviço prestado 31 .…”

Using Public Data to Predict Demand for Mobile Health Clinics

“…In contrast, our work considers temporal features and makes real-time forecasting possible. Reed et al (2019) strictly use patient survey data and focus only on the perception of clinic quality. The paper examines associations between multiple features, such as perceived quality of care, travel distance, and patient utilization of alternative health care clinics, using multiregression models on the survey data.…”

“…Despite its importance, only a limited number of studies discuss forecasting client demand for mobile clinics. Existing works use either static features from census data (Majeed et al 2021) which do not reflect demand dynamics, or patient survey data (Reed et al 2019) which may violate patient privacy requirements, suffer from selection bias, or may not be available.…”

Family Support and Social Support Associated with National Essential Public Health Services Utilization among Older Migrants in China: A Gender Perspective

“…In general, these studies found that NEPHS utilization was unsatisfactory, e.g., 58% not establishing a health record, 64% not enrolling in a yearly medical check-up, and 46% not seeking medical service when needed. Identified barriers to NEPHS utilization included limited-service accessibility [12], poor health status, a limited number of local friends, and lacking health insurance [7][8][9][10][11]. Some of these identified barriers fell into the domain of support, which is an enabling factor of service utilization [13,14].…”