Factors affecting one's health care choice

1999 ◽  
Author(s):  
Chi-wan, Nelson Ho
2020 ◽  
Vol 2 (2) ◽  
pp. 31-35
Author(s):  
Trishna Shrestha ◽  
Sneha Pradhananga ◽  
Kabita Hada Batajoo ◽  
Manjita Bajracharya

Introduction: Patients leaving against the advice of the treating team before being certified as fit is a major concern and challenge for the treating professionals as it possesses adverse medical outcomes. This study hence aimed at identifying the prevalence and major factors affecting such discharges so that advocacy can be done to help prevent it. Methods: A descriptive cross-sectional study was conducted at emergency department of a tertiary center in Lalitpur from 15th May 2019 to 15th August 2019. All the patients visiting the emergency department were included in the study and a non-probability purposive sampling method was used excluding the patients who denied giving reasons for them leaving against medical advice. Data was collected using pre-structured questionnaire and analyzed using SPSS-v21 software. Results: A hundred and fifteen patients (4.08%) left against medical advice out of 2812 patients who presented to emergency department. There were 63 male patients (54.8%), 75 patients of the total patients in the age group of 15-44 years (65.2%) and those living within a distance of 1km from the hospital (53%). The most common reason for the patients leaving against medical advice was found to be due to financial constraint (38.3%) followed by preference to other hospitals (16.5%). Conclusion: Patients leaving against medical advice possesses a small percentage of actual hospital admissions but is still a major health concern as it drastically increases the morbidity, re-admission rates and total health-care costs. Hence, understanding the general characteristics and predictors of such discharges is of utmost importance to help improve the patient outcome and reduce the health-care costs.  


Author(s):  
Pinar Döner ◽  
Kadriye Şahin

Abstract Purpose: Reproductive health includes the capability to reproduce and the freedom to decide. In this context, both women and men have rights. In this study, it is aimed to reveal the obstacles in using these rights and to describe perceptions on marriage and family planning (FP) of Syrian women and men and to increase awareness for developing new policies on the Primary Health Care. Methods: The study was conducted using qualitative method, consisting of in-depth interviews with 54 participants; 43 women and 11 men who had to emigrate from varied regions of Syria at different times since 2011. Syrian women living in Hatay, in the south of Turkey were identified from Primary Health Care Center. Most of the Syrian women had given birth to the first two children before the age of 20 years. The interviewees were selected by purposive and snowball sampling. Results: The result was examined under seven headings: knowledge about FP and contraceptive methods, hesitation about contraceptive methods, emotional pressure of family and fear of maintaining marriage, embarrassing of talking about sexuality and contraception, the effects of belief and culture on contraception, psychological reflections of war, and changes in the perception of health during the process of immigration. The most significant factors affecting the approaches to FP and contraceptive methods of the women in this study were determined to be education, traditions, economic status, and religious beliefs. The most important factors affecting participants’ FP and contraceptive method approaches are education, cultural beliefs, economic status, and religious beliefs. Conclusions: The primary healthcare centers are at a very strategical point for offering FP services to help address patients’ unmet contraceptive needs and improve pregnancy outcomes. More attention should be paid to social determinants that influence the access to reproductive health. Moreover, efforts can be done to address gender inequality that intercept FP. The most important strategy for primary health systems to follow the gender barriers that hinder access to FP services and men are empowered to share responsibility for FP.


2021 ◽  
Vol 6 (2) ◽  
pp. e003907
Author(s):  
Ran Liao ◽  
Yaqian Liu ◽  
Shunzhuang Peng ◽  
Xing Lin Feng

BackgroundChina set out the vision to establishing a hierarchical medical system, with primary health care (PHC) facilities serving health care users’ first contact. Common ailments were listed, supported by a series of auxiliary policy measures. We aim to assess whether these policies were effective to prompt users’ preference to PHCs within these contexts.MethodsUsing data from three waves of National Health Service Survey, we examined trends in care users’ first contact with PHC facilities in Jilin, a north eastern province, during 2008–2018. We analysed trends and factors affecting care users’ choices, stratified by type of diseases and urban–rural settings.ResultsFrom 38 823 respondents, the survey identified 3302 health care users who sought outpatient care. 54.92% and 82.49% with diseases recommended to PHC, in urban and rural Jilin, respectively, contacted PHC facilities first. While 33.51% and 61.19% with diseases not recommended to PHC did so. Care users’ first contact with PHC facilities followed an inverse U shape during 2008–2018. Such trends were more profound among care users with hypertension and/or diabetes. Neither social health insurance coverage nor contracting with family doctors was associated with care users’ first contacts. Only 1.25% care users had referral experiences. Low perceived quality was the main barrier to choose PHC facilities.ConclusionHealth care users sought PHC in a chaotic manner in Jilin. None of the recent efforts seemed effective in prompting their preference to PHC facilities. Without levering quality of PHC, an effective hierarchical medical system could be hardly forged in China.


2013 ◽  
Vol 69 (3) ◽  
Author(s):  
N.P. Ntamo ◽  
D. Buso ◽  
B. Longo-Mbenza

Background: Stroke is a major cause of disability inthe world and its long term effects require adherence to physiotherapyprotocols for optimal rehabilitation. Clinical impression of data fromMthatha General Hospital (MGH) Physiotherapy Department revealedthat there was poor attendance of outpatient physiotherapy by strokepatients discharged from MGH and this had negative effects on outcomesand health care costs.Objective: To determine the extent and the socio-demographic reasonsfor poor attendance for outpatient physiotherapy by stroke patients.Methods: An observational descriptive study was conducted using arandomly selected sample of 103 stroke patients from a population of 139who attended physiotherapy in MGH in 2007. Structured interviews wereconducted and SPSS was used for data analysis.Results: The majority (86%) of patients did not attend physiotherapy until discharge from the Physiotherapy Department. Themajor reasons for poor attendance were lack of finances (95%), migration to other areas (36%), and living a long distance fromMGH (38%).Conclusion: Almost 9 out of 10 stroke patients fail to attend for outpatient physiotherapy because of lack of finances.Recommendation: Development of a Provincial Rehabilitation Policy with specific reference to decentralization of rehabilitationservices to address unavailability of physiotherapy services at clinics and health care centers which are proximal to the patients’residential areas is recommended.


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