Need For Health Care Services Research Articles

Clusters from chronic conditions in the Danish adult population.

Multimorbidity, the presence of 2 or more chronic conditions in a person at the same time, is an increasing public health concern, which affects individuals through reduced health related quality of life, and society through increased need for healthcare services. Yet the structure of chronic conditions in individuals with multimorbidity, viewed as a population, is largely unmapped. We use algorithmic diagnoses and the K-means algorithm to cluster the entire 2015 Danish multimorbidity population into 5 clusters. The study introduces the concept of rim data as an additional tool for determining the number of clusters. We label the 5 clusters the Allergies, Chronic Heart Conditions, Diabetes, Hypercholesterolemia, and Musculoskeletal and Psychiatric Conditions clusters, and demonstrate that for 99.32% of the population, the cluster allocation can be determined from the diagnoses of 4-5 conditions. Clusters are characterized through most prevalent conditions, absent conditions, over- or under-represented conditions, and co-occurrence of conditions. Clusters are further characterized through socioeconomic variables and healthcare service utilizations. Additionally, geographical variations throughout Denmark are studied at the regional and municipality level. We find that subdivision into municipality levels suggests that the Allergies cluster frequency is positively associated with socioeconomic status, while the subdivision suggests that frequencies for clusters Diabetes and Hypercholesterolemia are negatively correlated with socioeconomic status. We detect no indication of association to socioeconomic status for the Chronic Heart Conditions cluster and the Musculoskeletal and Psychiatric Conditions cluster. Additional spatial variation is revealed, some of which may be related to urban/rural populations. Our work constitutes a step in the process of characterizing multimorbidity populations, leading to increased comprehension of the nature of multimorbidity, and towards potential applications to individual-based care, prevention, the development of clinical guidelines, and population management.

Access to specialized health care services among older Canadians.

Canada is experiencing rapid population aging, which has a wide range of implications, including an increased need for health care services. However, very few studies have examined use of specialized health care services (e.g., visits to medical specialists, non-emergency tests, and surgeries) among older Canadians. Data from the Canadian Health Survey on Seniors - 2019/2020 were used to examine specialized health care service use among older Canadians. Latent class analysis was calibrated using a nationally representative sample of 39,047 Canadians aged 65 years or older to identify distinct patterns of need factors related to health care service use. Multivariable logistic regression, stratified by gender, was used to examine the association of predisposing characteristics, enabling resources, and need factors with specialized health care service use. In 2019/2020, an estimated 2.6 million older Canadians (43.4%) visited medical specialists, 1.4 million (23.2%) got non-emergency tests, and 0.6 million (10.4%) had non-emergency surgeries. Among those, 15.6% reported experiencing difficulties accessing services. Women were less likely than men to have visited medical specialists and have received non-emergency tests. Lower education was consistently associated with lower odds of specialized health care service use. Individuals in the multimorbidity, high stress-multimorbidity-disability, and poor physical and mental health classes were more likely than those in the comparatively healthy class to use specialized health care services and to experience difficulties accessing them. Findings of this study highlight gender differences and the importance of considering multidimensional need factors - ranging from physical health to mental health to psychosocial factors - in examining use of specialized health care services.

Network visualization to interpret which healthcare services are central to people living with HIV.

To employ network analysis to identify the central healthcare service needs of people living with HIV (PLWH) for integrated care. Cross-sectional survey. A list of healthcare services was identified through literature reviews, expert workshops and validity evaluations by PLWH. A total of 243 PLWH participated at five hospitals and self-reported their need for healthcare services on a four-point Likert scale. Centrality of healthcare service needs was analysed using network analysis. The mean score for 20 healthcare service needs was 3.53 out of 4. The highest scoring need, "Precaution for interaction between antiretroviral therapy and other drugs," received a rating of 3.73 but had a centrality of only 0.31. The most central node in the network of healthcare service needs, "Information and coping with opportunistic infections," had a strength centrality of 1.63 and showed significant relationships with "non-HIV-related medical services (e.g., health check-ups)" and "Regular dental services." The correlation stability coefficient, which quantifies the stability of centrality, was 0.44 with an acceptable value. The most central need was information on opportunistic infections that had connections with many nodes in network analysis. By interpreting the relationships between needs, healthcare providers can design interventions with an integrative perspective. Network visualization provides dynamic relationships between needs that are unknown from the score scale by presenting them graphically and qualitatively. Using network analysis to interpret need assessment offers an integrated nursing perspective. Coping with opportunistic infection is central to connecting the chain of healthcare. This study highlights the multifaceted understanding of patients' needs that nurses gain when they conduct network analysis. We adhered to the STROBE checklist. No patient or public contribution.

Drug-related Offences in India: Observations and Insights from the Secondary Analysis of the Data from the National Crimes Record Bureau

Background: People who use psychoactive substances that are illicit have increased chances of coming into contact with the law enforcement and criminal justice systems for different reasons. The problem statement in terms of the need for healthcare services for such people is yet to be defined and quantified in India. Methods: We used the data collected by the National Crimes Record Bureau for the years 1986 to 2021. We assessed the profile of offences registered under the Narcotic Drugs and Psychotropic Substances Act (NDPS), 1985 over the successive years in India. We also made comparisons between the offences for possession for personal use/consumption and for trafficking of narcotic drugs and psychotropic substances at the national level and at the level of states and union territories in the country. Results: The percentage of these arrests, charge sheets and convictions as part of total Special and Local Laws (SLL) has increased over the years, showing a positive monotonic trend. A large percentage of those arrested were males. A higher percentage of females were arrested and charge-sheeted for trafficking than for personal use or consumption. The percentage of total persons arrested, charge-sheeted and convicted for possession of drugs for personal use/consumption was greater than that of those arrested for possession of drugs for trafficking for all years from 2017 to 2021. There were significant associations between gender and the types of offense. The highest rates of offences were reported from some north-western states, north-eastern states and Kerala. Conclusion: The findings help us make a strong argument in favour of strengthening the health sector response for people who use psychoactive substances and are in contact with the law enforcement and criminal justice systems in the country.

First, Seek to Understand: Deconstructing the Concept of Poverty for Nursing Education

Poverty, an important social determinant of health, is a multifaceted issue that impacts the health of individuals, families, and communities. People who live in impoverished communities have limited access to many necessary resources. This deficit often results in increased risk for mental illness, chronic disease, higher mortality, and lower life expectancy and greater need for healthcare services. There is a call for nurse educators to provide multiple opportunities throughout curricula for students at all levels to develop competencies to assess and intervene in outcomes impacted by social determinants of health. Doing so requires a perspective of empathy, grounded in cultural humility, to advance health equity and advocate for persons facing challenges, such as those who experience poverty. This article provides an overview of poverty in the context of the social determinants and discusses strategically designed experiential learning experiences, such as simulations and community-academic partnerships. An exemplar of an interprofessional community-academic partnership is provided to illustrate an ongoing successful effort that has fostered a deeper understanding of the lived experience of poverty for students of nursing and other professions.

Effects of 3S business intelligence systems for nursing students: a repeated-measures randomized control trial

BackgroundThe growing need for healthcare services as a result of a consistently rising prevalence of chronic diseases and rapid population aging calls for a new set of activities and practices. Therefore, we developed a program—3S (Simple, Smart, and Speed) Business Intelligence Systems (3S-BIS), which is an ERP software system that helps nursing business to support nursing entrepreneurship —and analyzed its effects on nursing students.MethodsA repeated-measures randomized controlled trial was performed with two groups: experimental (n = 29) and control (n = 30) groups. The former group underwent the five-day 3S-BIS education program. Each session comprised four components: lectures 1 and 2, simulation case study, and debriefing. Post-tests were performed immediately post-intervention and four and eight weeks later. The effectiveness was measured using the following variables: simulation design assessment, evaluation of educational practices in simulation, education satisfaction, self-efficacy for learning, and entrepreneurship. The differences before and after intervention between the experimental and control groups were analyzed using the Friedman test. The Mann–Whitney U test was used for comparisons between groups at each time point, and the Wilcoxon signed-rank test was used for comparisons within groups at each time point.ResultsPost-intervention (8 weeks after intervention), the experimental group demonstrated higher simulation design assessment (z = -3.88, p = < .001), evaluation of educational practices in simulation (z = -3.34, p = .001), education satisfaction (z = -3.11, p = .002), self-efficacy for learning (z = -3.04, p = .002), and entrepreneurship (z = -2.15, p = .031) compared to controls. Furthermore, simulation design assessment score in the experimental group significantly differed between T1 (immediately after intervention) and T0 (baseline), and between T3 (8 weeks after intervention) and T0. Evaluation of educational practices in the simulation, education satisfaction, and self-efficacy also significantly differed between T1 and T0, and between T3 and T0. Entrepreneurship significantly differed between T3 and T2 (4 weeks after intervention), and between T3 and T0.ConclusionsThe 3S-BIS program contributes to enhancing nursing start-up competency. Subsequent studies should evaluate the effects of the program on nurses who work in home healthcare services.

Socioeconomic inequality in unmet outpatient healthcare needs among people living in urban informal settlements in Sanandaj city, Iran

BackgroundThe growing trend of informal settlements is a serious humanitarian crisis. Unmet need for health care services is an indicator to measure the state of equality and access to healthcare services. This study, for the first time in Iran, examined the prevalence of unmet needs for outpatient healthcare services and related socioeconomic inequalities among residents of informal settlements in Sanandaj city.MethodsThis cross-sectional study was conducted on informal settlements of Sanandaj city with a sample size of 1345 people. Data were collected using a questionnaire. Multivariate logistic regression was used to determine significant predictors of unmet needs for healthcare services. Concentration index (C) and concentration curve (CC) were calculated to measure inequality in the prevalence of unmet needs for healthcare services.ResultsThe prevalence of unmet needs for outpatient healthcare services was 31.7%. Financial and physical barriers were the most common reasons for not using the needed services. The highest unmet need was related to dental (80.6%) and rehabilitation services (78.8%). Being elderly with about 2.3 times (OR: 2.37, 95% CI: 1.19–4.75), not having a job with about 1.7 times (OR: 1.70, 95% CI: 1.13–2.57) and having a low economic status with about 4 times (OR: 4.46, 95% CI: 2.39–9.70) increased the odds of experiencing unmet need for outpatient healthcare services. The value of concentration index showed that unmet need for outpatient healthcare services was significantly concentrated among people with lower economic status (C= -0.330, 95% CI: -0.432 to -0.227).ConclusionThe unmet need is high among people living in informal settlements of Sanandaj city and a significant part of the residents of these settlements does not have access to required healthcare services. Regardless of the needs of people living in these settlements, who constitute a large population of Iran, access to universal health coverage is not possible in such areas. Removing the identified obstacles and causes behind the unmet needs requires the interdisciplinary participation of all actors, including the government, the nation, and civil society.

Health disparities among illegal immigrants and homeless people in the USA: a struggle within

Undocumented immigrants in the United States face significant barriers in accessing healthcare services, which contribute to health disparities. This population is often affected by homelessness due to limited access to affordable housing, limited employment opportunities, language barriers, fear of deportation, and lack of social support. Homelessness and the fear of deportation can lead to stress, anxiety, and physical illness among undocumented immigrants, highlighting the need for healthcare services tailored to their unique needs. Access to healthcare is further hindered by a lack of health insurance coverage, financial constraints, language and cultural barriers, and the ineligibility for public health insurance schemes. Undocumented immigrants who are homeless encounter additional challenges, including difficulties in accessing resources, navigating the healthcare system, and facing societal discrimination. This article focuses on the barriers faced by undocumented migrants in the United States regarding healthcare access and proposes feasible solutions to promote health equity and advance universal health coverage in the country. The absence of health coverage for undocumented migrants undermines the concept of universal healthcare in the USA, as it excludes a significant portion of the population from accessing essential healthcare services. Hence, there is a need for comprehensive immigration reform and policies that ensure impartial access to healthcare. Practical solutions include establishing culturally competent care, implementing mobile clinics or street medicine programs, fostering collaborative relationships with nonprofit organizations, advocating for policies safeguarding the rights of undocumented immigrants, and enhancing data collection techniques.

Use of outpatient healthcare services before and after the onset of unemployment

Abstract Background The onset of unemployment may entail adverse health effects and, thus, increase the need for healthcare services. On the other hand, the onset of unemployment may weaken access to the healthcare services, which may as such decrease the overall use of healthcare services. The aim was to examine the use of outpatient healthcare services in different sectors of healthcare before and after the onset of unemployment and to study whether job loss affected the use of these services. Methods Longitudinal individual-level register-based data was utilized on all individuals living in the City of Oulu, Finland, who became unemployed in 2017 (N = 1,999), their propensity matched controls (N = 1,999), and unmatched controls (N = 58,459) in a quasi-experimental design. Use of outpatient healthcare services was examined in one-month periods from 12 months before to 12 months after the onset of unemployment. Several socio-demographic factors, along with sickness and employment histories, were used for propensity score matching. Difference-in-differences analysis was used to measure the differences in the use of outpatient healthcare services between the unemployed and their matched controls. Results The use of healthcare services decreased significantly after the onset of unemployment. This was due to a decrease in the use of occupational healthcare services. No change related to job loss was observed in the use of public or private healthcare services. The number of healthcare visits increased again after the unemployment ended. Difference-in-differences analyses showed that compared to propensity score matched controls, becoming unemployed reduced the use of healthcare services. Conclusions When access to occupational healthcare services ceases, other healthcare services do not appear to fill the gap among those who become unemployed. Adequate healthcare services should be guaranteed to all population groups equally based on need, irrespective of the labour market status. Key messages • The overall use of outpatient healthcare services decreases significantly after job loss in Finland because of a decrease in the use of occupational healthcare services. • Adequate and easily accessible healthcare services should be guaranteed to all population groups equally based on need, irrespective of the labour market status or other socio-demographic factors.

Human Factors Considerations for Quantifiable Human States in Physical Human-Robot Interaction: A Literature Review.

As the global population rapidly ages with longer life expectancy and declining birth rates, the need for healthcare services and caregivers for older adults is increasing. Current research envisions addressing this shortage by introducing domestic service robots to assist with daily activities. The successful integration of robots as domestic service providers in our lives requires them to possess efficient manipulation capabilities, provide effective physical assistance, and have adaptive control frameworks that enable them to develop social understanding during human-robot interaction. In this context, human factors, especially quantifiable ones, represent a necessary component. The objective of this paper is to conduct an unbiased review encompassing the studies on human factors studied in research involving physical interactions and strong manipulation capabilities. We identified the prevalent human factors in physical human-robot interaction (pHRI), noted the factors typically addressed together, and determined the frequently utilized assessment approaches. Additionally, we gathered and categorized proposed quantification approaches based on the measurable data for each human factor. We also formed a map of the common contexts and applications addressed in pHRI for a comprehensive understanding and easier navigation of the field. We found out that most of the studies in direct pHRI (when there is direct physical contact) focus on social behaviors with belief being the most commonly addressed human factor type. Task collaboration is moderately investigated, while physical assistance is rarely studied. In contrast, indirect pHRI studies (when the physical contact is mediated via a third item) often involve industrial settings, with physical ergonomics being the most frequently investigated human factor. More research is needed on the human factors in direct and indirect physical assistance applications, including studies that combine physical social behaviors with physical assistance tasks. We also found that while the predominant approach in most studies involves the use of questionnaires as the main method of quantification, there is a recent trend that seeks to address the quantification approaches based on measurable data.

Healthcare Service Needs of Orphans and Vulnerable Children in Orphanages and Barriers Caregivers face in meeting their Healthcare Service Needs: A Mixed Method Research

ABSTRACT Poor health and well-being among orphans and vulnerable children (OVC) in orphanages has been documented in literature, and evidence has shown an association between access to healthcare and well-being among this population. This study assessed the healthcare service needs of OVC and explored the barriers their caregivers face in meeting their healthcare service needs using a mixed method research approach. The study utilized a multi-stage sampling technique in selecting 384 OVC and 14 caregivers that participated in the study. Data were collected using pre-tested questionnaire and interview guide. The quantitative data were analyzed using Statistical Product and Service Solutions (SPSS) version 23, while the qualitative data were analyzed using thematic and content analysis. The result of the study shows that regular health assessment while in the orphanage tops the list of health services needed by OVC; this was followed by health assessment before or during admission into orphanages and facility visits for management of common illness by health professionals while health education for the children and caregivers ranked third. Mental healthcare was the least need reported by the children. From the caregivers’ perspectives, financial, structural and psychological barriers emerged as major themes for barriers faced in meeting the healthcare service needs of OVC. The study concluded that OVC are mainly in need of regular health assessment and treatment of common ailments during facility visits by health professionals. The study further shows that caregivers face significant barriers in meeting the healthcare service needs of OVC.

Determinants of Demand for Health Care Services by Rural Households

The study looked into the factors that influence rural families in the Akinyele Local Government's need for health care services. Two hundred (200) questionnaires were employed to collect certain important and pertinent data. Regression analysis, percentages, and frequency distribution statistics are some of the techniques employed. This frequency and the percentage allow us to understand how the respondents feel about the queries posed and answers provided. The regression analysis was utilized to determine the variables' sign and size as well as their significance. The regression analysis shows that price of healthcare service, the cost of drug, educational qualification and the distance to health centres are statistically significant in determining the demand for health care services among the people in Akinyele local government area while income, age and gender are statistically insignificant. As price of healthcare services, cost of drugs and distance to health centres are significant at 5% level of significance, education qualification is significant at 10% level of significance.

Palliative care in advanced Huntington’s disease: a scoping review

BackgroundAs Huntington’s disease (HD) is a progressive disease for which there is no cure yet, patients in the advanced stage of HD may benefit from palliative care.ObjectiveTo review the literature focusing on palliative care in advanced stage HD, and the level of evidence.MethodsPublications between 1993 and October 29th, 2021 from 8 databases (Embase, Web of Science, Cochrane, Emcare, PsycINFO, Academic Search Premier, PMC PubMed Central and Pubmed) were included. The literature was deductively classified based on topics that are part of the definition of palliative care, or as care-related topics that emerged from the literature. Levels of evidence I (high) – V (low) were determined as defined by the Joanna Briggs Institute.ResultsOur search resulted in 333 articles, 38 of which were included. The literature covered four domains of palliative care: physical care, psychological care, spiritual care, and social care. Four other topics in the literature were: advance care planning, end-of-life needs assessments, pediatric HD care, and need for health care services. Most literature was underpinned by a low level of evidence, except for the topics on social care (Level III-V), advance care planning (Level II-V) and end-of-life needs assessments (Level II-III).ConclusionsTo deliver adequate palliative care in advanced HD, both general and HD-specific symptoms and problems need to be addressed. As the level of evidence in existing literature is low, further research is essential to improve palliative care and to meet patient’s wishes and needs.

Studi Kualitatif Layanan Kesehatan Yang Diterima Orang Dengan HIV

Comprehensive health care service is right for people living with HIV / AIDS. It is important to know and dig deeply the need of healthcare services among people living with HIV as a vulnerable group. Exploration of health care provider services received by people living with HIV can provide a thick description related to the process of care and treatment. In-depth interviews conducted in nine people living with HIV who utilize health care services in Jakarta. In this phenomenological qualitative study researchers have used the data analysis stage according to Stevick-Colaizzi. This study identifies the essence of the health care received by people living with HIV are health care services information, easy access to health care services, service before the test, service after the test, get ARVs and treatment of health complaints. The findings recommend health care providers further optimized in order to give real impact in the prevention of HIV / AIDS pandemic.

Variations in Emergency Service Utilization among Cancer Survivors: Results from the Pan-Canadian Experiences of Cancer Patients in Transition Study Survey.

The objective of this study was to examine variations in emergency service utilization (ESU) among cancer survivors during the first year after completing primary cancer treatment. In 2016, the Canadian Partnership Against Cancer collected survey responses from cancer survivors across Canada about self-reported ESU after completing primary cancer treatment. We included survey respondents diagnosed with nonmetastatic breast, hematologic, colorectal, melanoma, or prostate cancer. Multivariable, multinomial logistic regression analysis was used to examine factors associated with cancer survivors' ESU. Of the 5,774 cancer survivors included in our analysis, 22% reported ESU during the first year after completing their primary cancer treatment, 16% reported ESU one to three times, and 6% reported ESU more than three times. Factors significantly associated with frequent ESU included younger age, colorectal and hematologic cancers, more frequent primary care provider and oncology specialist visits, single or retired status, lower income, and self-reported lower quality of life. Our study identified factors associated with more frequent ESU among cancer survivors in the first year after completing primary cancer treatment. These factors highlight differences in cancer survivors' demographics, their ability to access and need for healthcare services, and the complexity of using ESU as a metric for quality improvement in survivorship care. These variations must be considered in quality improvement initiatives.

Management gaps of traumatic spinal cord injuries in war-torn low and middle-income nations: why has this massive problem garnered little attention? Editorial.

Management gaps of traumatic spinal cord injuries in war-torn low and middle-income nations: why has this massive problem garnered little attention? Editorial.

How do people with disabilities in three regions of Guatemala make healthcare decisions? A qualitative study focusing on use of primary healthcare services.

Research has demonstrated that persons with disabilities, despite their greater need for healthcare services, often experience greater barriers to accessing healthcare including primary healthcare. Data and interventions on access to primary healthcare for persons with disabilities to date appear to concentrate more on access and quality issues once the person with a disability has initiated the healthcare seeking process, with less emphasis on how healthcare decisions are made at the personal or household level when one identifies a healthcare need. The aim of this study was to investigate how healthcare decisions are made by people with disabilities when they first identify a healthcare need. It is anticipated that gaining a better understanding of how such decisions are made will facilitate the development of interventions and approaches to improve access to primary healthcare services for this group. A qualitative study was undertaken in Guatemala. In-depth interviews were undertaken with twenty-seven adults with disabilities, including men and women with a range of impairment types and ages. Data were analyzed using thematic analysis to identify themes that influence the decision-making processes in accessing primary healthcare services for people with disabilities. Thematic analysis of the interviews along with exploration of three existing access to health frameworks and models, led to identification of four primary themes and development of a new conceptual framework highlighting the complex decision-making process undertaken by people with disabilities about whether to seek primary healthcare services or not when confronted with a healthcare concern. The themes include perceived severity of illness and need for treatment, personal attributes, societal factors, and health system characteristics. Using this new conceptual framework will facilitate the development of more effective policies and interventions to improve access to primary healthcare services for people with disabilities through greater understanding of the complex network of variables and barriers.

Inequalities in unmet need for health care services and medications in Brazil: a decomposition analysis

Unmet need is a metric used to assess the performance of health care systems throughout the world. One of the primary objectives of the Brazilian health care system is to identify ways to improve the health outcomes of all citizens. To accomplish this challenging goal, the health care system in Brazil will need to identify and eliminate barriers and provide timely and adequate access to health care services to all. This study assessed the performance of the Brazilian health care system by focusing on the unmet need for health care services and medications. We evaluated the Brazilian National Health Survey data collected in 2013 and 2019 to determine the magnitude of socioeconomic-related inequalities associated with unmet health care needs. Primary contributing factors were identified via decomposition analysis of the calculated concentration indices (CInds). Despite the availability of universal health care, 3.8% and 7.5% of the population in Brazil reported unmet needs for health care services and medications, respectively in the 2019 survey. Although the overall unmet need for medications remained unchanged between 2013 and 2019, CInd analysis revealed significant pro-poor inequalities with respect to unmet needs for both health care services and medications. The overall magnitude of these inequalities was higher in the poorer regions of the country. The use of private health insurance as well as individual health and socioeconomic status contributed significantly to the inequalities associated with unmet needs for health care services and medication throughout Brazil. Policy interventions should focus on improving access to health care services, extending coverage to include pharmaceuticals, and targeting both financial and non-financial barriers to obtaining care, particularly those experienced by the poor and vulnerable populations in Brazil. None.

THE MORBIDITY RATE OF GENITOURINARY DISEASES ACCORDING TO THE DATA ON POPULATION RECEIVING MEDICAL CARE IN A MULTIFUNCTIONAL HEALTH CARE FACILITY.

The aim: Establishing the characteristic features and morbidity rate of genitourinary diseases in order to substantiate the need for health care services. Materials and methods: The article uses bibliographic, medical, statistical and content analysis, as well as analytical methods. We have analyzed the sex-age characteristics of the morbidity rate of genitourinary diseases, with the morbidity rates among different sex-age groups of the population in 2015-2022 evaluated. Results: Diseases of the genitourinary system constitute a significant share in the overall structure of the morbidity rate (7.3%-10.6%) and disease prevalence (6.1%-7.3%) among adults. In 2015-2022, the dynamics of the morbidity rate of genitourinary diseases and their prevalence were characterized by a constant increase until 2019, with a subsequent decrease until 2022. Such trends in the morbidity rate and prevalence of genitourinary diseases among people may be related to the impact of the COVID-19 pandemic, which led to the restricted access to health care services as a result of taking measures to prevent the spread of infection, excessive load on the network of health care facilities within the pandemic period, etc. The features of prevalence and dynamics of the incidence of genitourinary diseases in adolescents, adults, and persons of older age groups are determined. Conclusions: The identified sex-age characteristics of the morbidity rate of genitourinary diseases, prevailing nosologies in certain age and sex groups will become the basis for substantiating measures to improve the quality of medical care, taking into account the principle of patient centricity and integration of care.

Exploring health seeking behaviour among incidentally diagnosed HIV cases in Rawalpindi, Pakistan: A qualitative perspective.

To identify the determinants of health-seeking behaviour among incidentally diagnosed cases of HIV and to explore the patterns of care seeking behaviour among these HIV infected persons. The qualitative study based on the grounded theory was conducted from February to September 2019 at the Armed Forces Institute of Transfusion, Rawalpindi, Pakistan, and comprised incidentally diagnosed new cases of human immunodeficiency virus. Data was collected using in-depth interviews to understand how local environments and settings impact healthcare-seeking behaviour. Data was analysed using the constant comparison method. Of the 12 patients, 10(83.3%) were male, 1(8.3%) female and 1(8.3%) transgender. The mean age of the sample was 31±5 years. Of the total, 10(83.3%) patients were receiving free antiretroviral treatment from government hospitals in Rawalpindi/Islamabad, while 2 (16.7%) opted for some alternative form of healthcare. Ten (80%) were married and were carrying the diagnosis for >6 months. Processing of human immunodeficiency virus status, value placed in one's own health, experiences with healthcare provider and medication-related factors were the main themes that emerged from the data. Better counselling services, free-of-cost medication, positive patient-provider relationship and social support were the key players, while non-disclosure due to fear of stigma and beliefs about the disease were the main stumbling blocks. Value placed in one's own healthcare and thus the need for healthcare services, regardless of social norms, cultural reservations and personal beliefs, was the most important factor affecting the healthcare-seeking behaviour of human immunodeficiency virus patients.