The ecology of health care in a Belgian area

Abstract

Introduction: Focusing on the monthly prevalence of health problems and recourse to different levels of care of the population is an interesting approach to demonstrate the respective roles of different levels of health care. In the present study, the ecology of health care was studied in the region of Liè ge, Belgium. Method: A survey questioning people about their health problems was conducted in 2009 in two communes of the province of Liè ge. For each health problem, 'health care' was defined as contact with any qualified care provider. For each consultation, three elements were recorded: the profession of the health care provider; the place where the care was provided and the kind of health care received. Results: A total of 537 people were interviewed. The monthly prevalence of people who experienced a health problem during the previous month was 85.1%. The monthly prevalence of people who turned to a health care provider at least once during the month was 62.2%. The proportion of people turning to doctors, primarily local doctors, for a simple consultation was important (49.2%). Discussion: Our results are highly comparable with those of other studies. Recourse to a doctor is high (49%), which probably reflects the broad accessibility of health care in Belgium and maybe its overuse. Additional questions on the current and future organisation of the Belgian health care system are debated.

The Ecology of Medical Care in Korea

“…The proportion of those who had any health problem in an average month of 2012 was 93.9% of people aged 18 and over, but only 33.3% of them received ambulatory care at a clinic. As noted in Table 1 , this finding was consistent with the results of previous studies ( 8 , 13 , 20 , 26 ), though three studies ( 14 , 22 , 23 ) reported different patterns. According to a study conducted in Hong Kong ( 14 ), 15.9% of people having any kind of symptoms did self-management.…”

“…A large share of primary care in the health care system was observed in this study as well as in previous ones ( 8 , 13 , 14 , 18 , 20 , 22 , 26 ), as seen in Table 1 . However, adequate attention has not been paid to primary care in Korea.…”

“…This study has some limitations, mainly derived from the KHP data. Unlike some preceding research ( 8 , 13 , 14 , 17 , 18 , 26 ), we could not estimate the number of people aged less than 18 who experienced any health problem because an additional, individual survey was not conducted for this age group ( 28 ). There can be a dispute over the definition of health problem.…”

“…It is a nationally representative dataset. Unlike datasets used in previous studies ( 9 , 13 , 20 - 23 , 26 ), it was less affected by seasonal variation in medical utilization because its survey had been conducted all year round. In addition, while some previous studies used health insurance claim data ( 16 , 18 , 24 ) or registry data ( 17 ), the KHP includes data on health states, such as mental health problems and absenteeism, derived from an additional, individual survey, which enabled us to define people’s health problem experiences.…”

“…There can be a dispute over the definition of health problem. In some previous studies ( 8 , 13 , 14 , 20 , 22 , 23 , 26 ), researchers asked people to respond to whether they had any symptom or health problem during the past month, but the KHP survey had no similar question. Therefore, we defined health problem experience by combining the variables of mental health problems, being bed-ridden and absenteeism during the past month and chronic disease.…”