scholarly journals The ecology of medical care in Norway: wide use of general practitioners may not necessarily keep patients out of hospitals

2012 ◽  
Vol 1 (2) ◽  
pp. 28 ◽  
Author(s):  
Anne Helen Hansen ◽  
Peder A. Halvorsen ◽  
Olav Helge Førde
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
General Practitioners ◽  
Health Care Services ◽  
Medical Providers ◽  
Specialist Care ◽  
Cross Sectional ◽  
Care Services ◽  
And Gender ◽  
Complementary And Alternative

<em>Background</em>. Our aim was to investigate the pattern of self reported symptoms and utilisation of health care services in Norway. <em>Design and methods.</em> With data from the cross-sectional Tromsø Study (2007-8), we estimated population proportions reporting symptoms and use of seven different health services. By logistic regression we estimated differences according to age and gender. <em>Results</em>. 12,982 persons aged 30-87 years participated, 65.7% of those invited. More than 900/1000 reported symptoms or health problems in a year as well as in a month, and 214/1000 and 816/1000 visited a general practitioner once or more in a month and a year, respectively. The corresponding figures were 91/1000 and 421/1000 for specialist outpatient visits, and 14/1000 and 116/1000 for hospitalisations. Physiotherapists were visited by 210/1000, chiropractors by 76/1000, complementary and alternative medical providers by 127/1000, and dentists by 692/1000 in a year. Women used most health care services more than men, but genders used hospitalisations and chiropractors equally. Utilisation of all services increased with age, except chiropractors, dentists and complementary and alternative medical providers. <em>Conclusions</em>. Almost the entire population reported health related problems during the previous year, and most residents visited a general practitioner. Yet there were high rates of inpatient and outpatient specialist utilisation. We suggest that wide use of general practitioners may not necessarily keep patients out of specialist care and hospitals.

scholarly journals Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongjie Sha ◽  
Willa Dong ◽  
Weiming Tang ◽  
Lingling Zheng ◽  
Xi Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Minority Stress ◽  
Access To Health Care ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gender Minority ◽  
Care Services ◽  
Access To Health ◽  
And Gender

Abstract Background Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China. Methods This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service. Results Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98). Conclusions Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.

scholarly journals Perceptions and utilisation of complementary and alternative medicine practices among hospital patients in Bangladesh

2021 ◽  
Author(s):  
MD. SHAHJALAL ◽  
Jeffrey Gow ◽  
Md. Ashfikur Rahman ◽  
Md. Jakir Hossain ◽  
Md. Nafiul Alam Khan ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Health Care Services ◽  
Universal Access ◽  
Health Benefits ◽  
Cross Sectional ◽  
Care Services ◽  
Complementary And Alternative

Abstract Background Complementary and alternative medicine (CAM) has played an important role in providing universal access to essential health care services globally. Conventional medicine (CM) driven health care practices are well-developed in Bangladesh; however, millions of people utilise CAM-based healthcare services for specific health conditions or health benefits due to high out-of-pocket payment (74%) in Bangladesh, while the global average is only 32%. Lack of evidence exists about the perception and utilisation of CAM in Bangladesh. This study aimed to estimate the prevalence correlates of the perception and utilisation of CAM among patients who received health care at a tertiary hospital, Bangladesh. MethodsThis study comprised a cross-sectional study with 1,183 individuals from the cross-sectional survey among patients who received health care from Government Unani and Ayurvedic Medical College Hospital in Dhaka, Bangladesh. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on CAM health care services utilisation. Results Thirty-three percent of patients utilised CAM health care services, while 67% of patients sought conventional treatment before turning to CAM. CAM health care utilisation was significantly associated with young adult patients aged 26 to 45 years (AOR=6.26, 95% CI:3.24-12.07), patients without education (AOR=2.99, 1.81-4.93), and being married (AOR=1.79, 1.08-2.97). The apparent effectiveness, lower side effects, adequate patient satisfaction, and recommendations from others were the most prevalent reasons for using CAM.ConclusionCM plays a dominant role in health care provision in Bangladesh, with high-level patient satisfaction and health benefits. These results could be valuable for health policymakers as they explore prospects for integrating CAM and conventional medical services.

scholarly journals Use of health care services among Syrian refugees migrating to Norway: a prospective longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jasmin Haj-Younes ◽  
Elisabeth Marie Strømme ◽  
Jannicke Igland ◽  
Eirik Abildsnes ◽  
Bernadette Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
General Practitioner ◽  
Emergency Care ◽  
Health Care Services ◽  
Healthcare Services ◽  
Syrian Refugees ◽  
Specialist Care ◽  
Care Services ◽  
Use Of Health Care

Abstract Background Understanding the differential utilization of healthcare services is essential to address the public health challenges. Through the migration process, refugees move from one set of health risk factors to another and can face multiple healthcare challenges along their journey. Yet how these changing risk factors influence refugees’ use of health care services is poorly understood. Methods A longitudinal survey assessing health care utilization of 353 adult Syrian refugees was conducted; first in a transit setting in Lebanon and after one year of resettlement in Norway. The main outcomes are the utilization of general practitioner services, emergency care, outpatient and/or specialist care and hospitalization during the previous 12 months. Associations between use of healthcare services and several sociodemographic, migration-related and health status variables at both time points were found using regression analysis. We also analyzed longitudinal changes in utilization rates using generalized estimating equations. Results The use of general practitioner and emergency care increased after resettlement while outpatient/specialist care markedly dropped, and hospitalization rates remained the same. Undocumented status and poor self-rated health (SRH) prior to resettlement were identified as predictors for use of health care after arrival. After resettlement, higher health literacy, higher education, higher social support and poor SRH and quality of life were significantly associated with use of healthcare services. Conclusions Utilization of health services changes post migration to the destination country and are associated with migration-related and socio-demographic factors. Poor SRH is associated with use of services, both pre-arrival and post-resettlement. Our findings have implications for future resettlements, health care policies and service provision to newly arrived refugees with regard to both health needs as well as delivery of services.

Race and gender as factors in access to health insurance and utilization of health care services

2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Race And Gender ◽  
Care Services ◽  
Access To Health ◽  
And Gender

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

scholarly journals Pharmaceutical care in Brazil’s primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Patricia Sodré Araújo ◽  
Ediná Alves Costa ◽  
Augusto Afonso Guerra Junior ◽  
Francisco de Assis Acurcio ◽  
Ione Aquemi Guibu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Pharmaceutical Care ◽  
Health Care Services ◽  
Cross Sectional ◽  
Educational Activities ◽  
Health Team ◽  
Care Services ◽  
Primary Health

OBJECTIVE: To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals. RESULTS: From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were “pharmaceutical guidance” and “pharmaceutical care.” The registration of activities is mainly made in the users’ medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated. CONCLUSIONS: Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out to the professionals’ improvisation and effort. The small participation in educational activities of health promotion indicates little integration of pharmacists with the health team and of pharmaceutical services with other health actions

First Step in Obtaining Child Health Care: Selecting a Physician

PEDIATRICS ◽  
1988 ◽  
Vol 81 (3) ◽  
pp. 333-338
Author(s):  
Gerald B. Hickson ◽  
David W. Stewart ◽  
William A. Altemeier ◽  
James M. Perrin
Keyword(s):  
Health Care ◽  
Child Health ◽  
General Practitioners ◽  
Health Care Services ◽  
Child Health Care ◽  
Sources Of Information ◽  
Patient Decision Making ◽  
Care Services ◽  
Patient Decision ◽  
Study Results

To investigate the process by which families identified and selected their children's current physicians, a close-ended questionnaire was administered to 750 families in a mail panel. Of 630 responses (84.0%), 244 had children in the home; 229 (93.9%) identified a regular and current physician for their youngest child. However, parents did not spend much time or energy selecting a physician and rarely explored medical expertise in their decisions. Families averaged 1.2 sources of information consulted per decision; few considered more than two physician choices and infrequently considered alternative types of doctors (pediatricians v family or general practitioners). selection priorities ranked in order of importance concerned parents' perceptions of their doctors' communication skills, accessibility, and quality as determined by recommendations of friends or physicians. Parents appeared less concerned with issues of cost and convenience. Families selecting pediatricians differed from those selecting family and general practitioners in sources of information used and selection priorities. The survey also identified 84 families who had changed or seriously considered changing the physician who was caring for their youngest child. The most frequent dissatisfaction was the perception that an illness was not being managed adequately, followed by believing that the doctor or staff were rude or unconcerned. Families unhappy with pediatricians expressed different reasons from those unhappy with family or general practitioners. The study results provide insight about the first step in obtaining child health care services, a relatively unexplored area of patient decision making.

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