Effect Of Service Use Research Articles

Counselling on newborn danger signs for women in Bahirdar City, northwest Ethiopia: a community-based cross-sectional study

Background/Aims The prevalences of good knowledge and health-seeking practice for newborn danger signs are generally low in Asia and sub-Saharan African countries. There is limited information available about the effect of maternal and child health service use on this issue among mothers in Bahirdar. This study's aim was to assess the effect of service use on knowledge and health-seeking practice related to newborn danger signs among women with infants in Bahirdar. Methods This community-based cross-sectional study involved 392 women with infants aged less than 6 months, who used maternal and child health services in Bahirdar between 10 September and 10 October 2020. Bivariable and multivariable regression were used to identify service use factors associated with health-seeking behaviour and knowledge related to newborn danger signs. Results Most of the participants recognised that frequent vomiting (81.1%), high fever (73.0%) and convulsion (69.9%) were neonatal danger signs. Postnatal care counselling was strongly associated with health-seeking practice (adjusted odds ratio=1.9, P<0.001). Antenatal care counselling was strongly associated with knowledge of newborn danger signs (adjusted odds ratio=1.57, P<0.001). Conclusions The prevalence of maternal knowledge of newborn danger signs was lower compared to the literature. Similarly, the prevalence of health-seeking practice among mothers with an infant with a newborn danger sign was low. Interventions to improve the quality of antenatal and postnatal counselling are recommended.

The Effect of Health Service Use, Unmet Need, and Service Obstacles on Quality of Life and Psychological Well-Being in the First Year After Discharge From Spinal Cord Injury Rehabilitation

ObjectiveThis study examined the effects of health and rehabilitation service use, unmet need for services, and service obstacles on health-related quality of life (HR QoL) and psychological well-being after discharge from spinal cord injury (SCI) rehabilitation. DesignProspective cohort study, with participants followed up at 6 and/or 12 months after discharge from SCI inpatient rehabilitation. SettingCommunity setting. ParticipantsPeople with SCI (N=55; mean age 51y; 76.4% men; 61.8% traumatic injury; mean length of stay 137d). InterventionsNot applicable. Main Outcome MeasuresService Usage Scale, Service Obstacles Scale, the EuroQol-5D, and the Depression Anxiety and Stress Scale short form. Eight predictors of outcome were considered: service use (ie, use of general practitioner, medical specialist, nursing, and allied health, and rehospitalization), unmet need, and service obstacles (ie, finances and transport). Possibly important predictors of each outcome were identified via penalized regression, and a final model was fit using Bayesian hierarchical regression with a Gaussian or zero-inflated Poisson response distribution. ResultsFinancial obstacles were associated with a poorer HR QoL (β [95% credible interval]= −0.095 [−0.166 to −0.027]) and higher anxiety (odds ratio, OR [95% credible interval]=1.63 [1.16-2.23]). Rehospitalization was associated with a lower EuroQol visual analog scale (β= −11.2 [−19.7 to −2.5]) and, interestingly, lower anxiety (OR=1.63 [1.16-2.23]). Use of allied health was associated with higher anxiety (OR=2.48 [1.42-4.44]). ConclusionThe varying degrees of financial hardship experienced after injury with complex rehabilitation needs requires investigation, as does the interactive effects of service use, unmet need, and service obstacles on outcomes like QoL and psychological well-being.

Community Pharmacy Medicare Part D Consultations: Plan-Switching Decisions and Chronic Medication Adherence

Objectives: (1)To compare Part D plan switching for users and nonusers of a pharmacy-led Medicare Part D consultation service and (2) to evaluate the effect of service use on chronic medication adherence. Methods: This was a longitudinal study, occurring in one independently owned community pharmacy in Iowa. Medicare Part D beneficiaries who used the service were compared to nonusers. Dispensing data were used to compare planswitching and the effect of service use on chronic medication adherence between service users and nonusers. Proportion of days covered (PDC) was used to evaluate medication adherence. Results: In the 2017 and 2018 plan year, 79 and 138 Medicare beneficiaries used the service, respectively. These individuals were compared to 849 Medicare beneficiaries and a random sample of 101 beneficiaries in respective years. The respective switching rates for service users in 2018 and 2019 plan year were 43% and 15.9%, compared to 4% switching rates in both years for nonusers. Using the Medicare Part D consultation yielded a statistically significant positive effect on switching in both plan years (P values < .05) and a statistically significant positive effect on PDC between years (P value <.05). Conclusion: The use of a pharmacist-led Medicare Part D consultation resulted in increased plan switching and improved chronic medication adherence.

Effects of service use, family social capital and school social capital on psychosocial development among economically disadvantaged secondary school students in Hong Kong

This study investigates factors conducive to the success of young people growing up with economic disadvantage. Previous studies often focused on the risks and difficulties experienced by this cohort of young people; however, little attempt has been made to examine factors that help them thrive or escape from adversity. It is with this consideration in mind that this study examines the ways in which service use, family social capital and school social capital affect psychosocial development in such areas as mental health, positive identity, behavioural adjustment, resilience, academic success and overall accomplishment. The basic premise is that these three factors may have differential effects on youth outcomes. To test this conjecture, the study employs survey data collected from a territory-wide sample of 862 students from low-income families recruited from 14 secondary schools located in different districts of Hong Kong. The results support our hypotheses that service use, family social capital and school social capital have significantly positive effects on psychosocial development, although their individual effects differ across indicators of development. In addition, the two background characteristics of gender and public assistance reception have significant effects on developmental outcomes. The implications of the findings for further research and service provision are discussed.

Relationship between home care service use and changes in the care needs level of Japanese elderly

BackgroundWith the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels.MethodsThe participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician.ResultsIn the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to sustaining or improving the user's care needs level.ConclusionThere were different home service use in two groups (the sustained/improved group and the deteriorated group). Respite stay in a nursing home service use and more types of service use were related to experiencing a deterioration of care needs level in lower care needs level community-dwelling elderly persons in Japan. Further, medical management by a physician service was related to experiencing a deterioration of care needs level in higher care needs level community-dwelling elderly persons.

Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study

Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study