The ecology of medical care in Shanghai

Abstract

Background To better understand the distribution and consumption patterns of resources in different ethnic groups and at different levels of economic development, this paper chose to describe the healthcare seeking behavior in Shanghai. Methods The data are from the Sixth Health Service Survey of Shanghai, which encompasses 23,198 permanent residents. Descriptive analyses were conducted to estimate the number of patients who reported health-related symptoms and healthcare-seeking behaviors per 1,000 residents. Logistic regression analyses were conducted to examine differences in reporting health-related symptoms and healthcare-seeking behaviors by age, gender and area of residence. Results This paper have mapped the ecology of healthcare in Shanghai in 2018. Of 1000 individuals considered during a 1-month period, 444 reported sickness, 433 received treatment, 288 went to medical institutions, 195 went to primary medical institutions, 86 took a self-healing approach, 26 received TCM services, 7 were hospitalized, and 3 underwent surgery. Conclusions Age is a risk factor leading to disease, medical treatment, self-medication, medical institution visits, TCM service, hospitalization and surgery. But age is a protective factor in the use of primary health care services. By gender, the number of people receiving medical services was similar, but women were statistically more likely to have surgery. As the income level increased, the number of patients and people receiving medical services showed a decreasing trend. Compared with the local population, the probability of non-local people visiting medical institutions was lower and statistically significant. Compared with the people who had health insurance, fewer uninsured people reported sickness and utilized healthcare services.

The Ecology of Medical Care During the COVID-19 Pandemic in Japan: a Nationwide Survey

“…On the other hand, the number of visits at higher-level medical institutions such as university medical centers and emergency rooms, which accept patients with severe symptoms, and hospitalizations were at the same level as those before the pandemic. Although a cross-sectional survey is a common method for conducting the ecology of medical care studies, 8 , 9 , 11 health care utilization may be underestimated compared with a health diary method, which was used in previous studies in Japan. 14 , 15 However, the changes in health care utilization were drastic and cannot be explained by differences in the methods alone.…”

The Ecology of Medical Care During the COVID-19 Pandemic in Japan: A Nationwide Study

“…8 This framework was replicated in different countries worldwide and offered a useful tool to researchers and health care policymakers. [9][10][11][12] With a universal health coverage in Japan, the ecology of medical care has been investigated in 2003 and 2013. 13,14 Compared with the 2003 study, the participants in the 2013 study were reported to have fewer physician and emergency room visits and less overthe-counter (OTC) drug use, but reported higher frequency of complementary or alternative medicine (CAM) use.…”