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Service Utilization Patterns (service + utilization_pattern)
Selected AbstractsAttenuation of Racial Differences in Health Service Utilization Patterns for Previously Uninsured Children in the DeltaTHE JOURNAL OF RURAL HEALTH, Issue 4 2005Zola K. Moon MA ABSTRACT: Context: A school-based health insurance program for children of the working poor was conducted in 2 isolated, rural communities in the Lower Mississippi Delta region. The larger of the 2 communities had an array of locally available health care providers, whereas the smaller community did not. In response to this lack of available care, the project designed and delivered outreach programs, including transportation to providers. Purpose: The purpose of this paper is to examine the role of race, age, and gender in the relationships between the utilization of care and the impact of outreach programs. Method: General estimating equation models are used to examine the response of utilization variables to race, age, gender, and community. Four years of insurance claims data are analyzed. Findings: Race is seen to be an important component of utilization. The majority of participants were African American; however, children receiving prescription services, emergency room care, routine physician visits, and hospital outpatient services were more likely to be white. Outreach programs in vision and dental services were found to eliminate racial differences and increase utilization. A relatively strong gender effect was found in prescription, wellness, vision, and dental services. Conclusions: Previous research has shown differences by race in utilization of care. Our findings show that targeted outreach programs can significantly diminish these differences. Findings also suggest that barriers to health care for poor rural children are closely linked to transportation and availability of providers, not merely to cost of care or insurance. [source] Personal and social determinants of health services utilization by Mexican older peopleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2010Maria Isabel Peñarrieta De Córdova PhD de córdova m.i.p., mier n., curi e.j.m., gómez t.g., quirarte n.h.g. & barrios f.f. (2009) Personal and social determinants of health services utilization by Mexican older people. International Journal of Older People Nursing 5, 193,201 doi: 10.1111/j.1748-3743.2009.00193.x Background., Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. Objective., To examine personal and social correlates to health services utilization among Mexican older persons. Design and methods., This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson's chi-squared tests and logistic regression were used for data analyses. Results., Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. Conclusions., Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands. [source] Oral health-related quality of life among rural-dwelling Indigenous AustraliansAUSTRALIAN DENTAL JOURNAL, Issue 2 2010SD Williams Abstract Background:, There is limited information on the impact of poor oral health on Indigenous Australian quality of life. This study aimed to determine the prevalence, extent and severity of, and to calculate risk indicators for, poor oral health-related quality of life among a convenience sample of rural-dwelling Indigenous Australians. Methods:, Participants (n = 468) completed a questionnaire that included socio-demographic, lifestyle, dental service utilization, dental self-care and oral health-related quality of life (OHIP-14) factors. Results:, The prevalence of having experienced one or more of OHIP-14 items ,fairly often' or ,very often' was 34.8%. The extent of OHIP-14 scores was 1.88, while the severity was 15.0. Risk indicators for having experienced one or more of OHIP-14 items ,fairly often' or ,very often' included problem-based dental attendance, avoiding dental care because of cost, difficulty paying a $100 dental bill and non-ownership of a toothbrush. An additional risk indicator for OHIP-14 extent was healthcare card ownership, while additional indicators for OHIP-14 severity were healthcare card ownership and having had 5+ teeth extracted. Conclusions:, Risk indicators for poor oral health-related quality of life among this marginalized population included socio-economic factors, dentate status factors, dental service utilization patterns, financial factors and dental self-care factors. [source] An analysis of post-booking jail diversion programming for persons with co-occurring disorders,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2004Dr Michael S. Shafer Ph.D. For persons with co-occurring disorders, interaction with criminal justice systems is a frequent occurrence. As a result, a variety of diversionary programs have been developed nationwide. In this study, a total of 248 individuals with co-occurring disorders of serious mental illness and substance use disorders who had been arrested and booked on misdemeanor charges participated in a post-booking jail diversion program in two urban communities. A quasi-experimental design was used with individuals assigned to diversion or non-diversion status based upon the decision processes of the mental health,criminal justice systems. The effectiveness of the jail diversion program was evaluated from a variety of sources, including structured interviews, behavioral health service utilization patterns, and criminal justice recidivism patterns. Analyses revealed general main effects for time on many of the outcome variables, with few main effects or interaction effects detected on the basis of diversion status (diverted versus non-diverted). Across all measures assessing mental health and substance abuse, study participants displayed improvements over time, irrespective of their diversion status or program location. Participants generally displayed no significant changes in their rates of accessibility to, or frequency of use of, the various mental health, substance abuse, and other services, and few changes for diversion status were detected with regard to service utilization. Although a number of indicators of criminality and violence were reduced over time, these reductions were statistically insignificant, with changes for diversionary status or time identified at follow-up. These results are discussed in light of their implications for jail diversion programming and future research in this area. Copyright © 2004 John Wiley & Sons, Ltd. [source] | ||||||||||