Odds Of Health Service Utilization Research Articles

Outpatient health service utilization and associated factors among Iranian older adults: based on Andersen’s behavioral model

ABSTRACT The aim of this study was to investigate the prevalence of the utilization of outpatient health services (OHSU) and the related factors among community-dwelling older adults in Tehran, Iran. A cross-sectional study was conducted from October to December 2019 among 1280 older adults aged 60 ≥, living in Tehran. Logistic regression analysis was used to determine the association between factors identified in the framework used in this study (predisposing factors, enabling factors, and need-related factors) and utilization of OHS in the previous month. SPSS Statistics (version 23.0; IBM) was used to analyze the data. The mean age of participants was 70.9 years. The prevalence of OHSU in the previous month was 90.21%. Overall, 59.6% reported good health status and 93.6% had at least one chronic disease. 32.8% of the older adults were satisfied with receiving the latest health services. Multiple logistic regression analyses revealed that the use of health services was higher in males, those with high monthly incomes, those living with a partner, and older adults with higher education. There was a significant association between not using substances and a lower odds of OHSU. Living alone had a significant association with lower odds of health service utilization among older adults. Thus, health care policies need to focus on social support and access to health services for older adults who live alone. Identification and targeting interventions toward older adults who do not utilize health services should be considered by policy makers and the health care system.

Modern Health Service Utilization and Associated Factors among Adults in Southern Ethiopia.

Background The Ethiopian government is striving to improve the health status of its population through the expansion and strengthening of primary health care services in both rural and urban settings of the country. The study aimed to measure modern health service utilization and associated factors in Wolaita Sodo town, Ethiopia. Method A cross-sectional study design was implemented from May to June 2019 in Wolaita Sodo town, Ethiopia. All 786 study participants were selected by multistage systematic random sampling. Data were collected by face-to-face interviews using a pretested structured questionnaire. Data were collected by an open data kit. Stata window version 15.0 was also employed for statistical analysis. Multiple logistic regression was conducted, and a 95% confidence interval was considered for interpretation. Result Health service utilization was 77.2% with (95% CI of 74.1%, 80.0%). In terms of health facilities in which they visit, first 50.6% were at the public health center and 25.5% of them were at Teaching and Referral Hospital. Respondents with marital status married and widowed have higher odds of utilizing health services compared to single marital status (AOR: 2.96; 95% CI: 1.7–5.2 and 9.0; 95% CI: 1.69–48.0), respectively. Respondents with middle and highest wealth status have higher odds of health service utilization than poor wealth status with AOR (1.75 95% CI 1.03–2.97 and 1.58 95% CI; 1.01, 2.77). Similarly, respondents who had chronic disease and perceived poor health status have higher odds of health service utilization. Conclusion Modern health services utilization was found to be unsatisfactory. Being married, wealth status being middle and high, having chronic health conditions, and having poor perceived health status were found to have a statistically significant association with health service utilization.

Loneliness and Health Service Utilization among the Rural Elderly in Shandong, China: A Cross-Sectional Study.

Objectives: To examine the prevalence of loneliness and to explore the association between loneliness and health service utilization among the rural elderly in Shandong Province, China. Methods: A total of 5514 rural people aged 60 and above from Shandong Province, China, were enrolled in this study. Loneliness was used as a binary variable based on a single-item question. Health service utilization was measured by recent two-week physician visits and annual hospitalizations rates. Multiple logistic regression analysis was performed to examine the association between loneliness and health service utilization. Results: The prevalence of loneliness among the rural elderly in Shandong, China, was 25.0%. Loneliness was associated with higher rates of recent two-week physician visits (OR = 1.260, p < 0.01) and annual hospitalizations (OR = 1.183, p < 0.05). The regression results also showed that self-rated health status and chronic conditions were significant and positively associated with both physician visits and hospitalizations rates. Conclusions: Loneliness had a significant association with higher odds of health service utilization among the elderly. The independent contribution of loneliness on health service utilization was smaller than self-rated health status and chronic conditions. Thus, healthcare policies need to shift from an emphasis on controlling health utilization and cost to a greater focus on enabling lonely older people to get more social support.