Optimal Health Services Research Articles

DESCRIPTION OF NURSES QUALITY OF WORK LIFE IN RSUD DR. M.M. DUNDA LIMBOTO

Most health workers in hospitals are nurses who have an important responsibility in providing health services. Quality of work life is an important issue in health organizations, has several impacts on nurses and nursing services. The low quality of work life of nurses can lead to feelings of frustration, incompetence, and feelings of guilt. If it continues, it can lead to an incident of turnover for nurses. Quality of Nursing Work Life (QNWL) is an important element for the nursing profession that will affect the quality of health services. The purpose of this study was to determine the quality of working life of nurses in RSUD Dr. M.M. Dunda Limboto.This research is a type of quantitative research using descriptive analysis with a cross-sectional approach. The research population of nurses was 272 people with a sample of 161 respondents using proportionate stratified random sampling technique. Data analysis using univariate test.The results showed that nurses who had a good quality of work life amounted to 124 respondents (77%), had a sufficient quality of work life amounted to 30 respondents (18.6%) and had a poor quality of work life amounted to 7 respondents (4.3%). Quality of working life of nurses in RSUD Dr. M.M Dunda Limboto was mostly in the good category with a percentage of 77%. This research is expected to be an input for hospitals in improving the quality of nurses' work so that they can provide optimal health services.

The Athena SWAN Process to Promote Gender Equity in Third-Level Education in Ireland

Introduction: Sexism and misogyny remains an ongoing threat to optimal health and medical services. An important factor in health and medical services is the education and training pipeline into these careers. A substantial body of literature demonstrates the impacts of sexism in third-level education and training institutions developing future health service staff. Athena SWAN accreditation is a benchmark designed to counter such institutional and individual sexist practices in education settings to foster equality. In recent years the Athena SWAN process has expanded to include professional and administrative staff, as well as academics. This process has also evolved to move beyond a narrow focus on gender, to also include other crucial issues such as race, sexuality and gender identity. Methods: This examination is based on the author’s role as a participant observer and critiques the Athena SWAN process in an Institute of Technology in Ireland. Results: This examination identifies a substantial number of deficits in the Athena SWAN process, as well as also identifying institutional resistance strategies to such gender equality work. Conclusion: The current Athena SWAN process in Ireland is critically flawed. Suggested strategies for those engaged in such work into the future are outlined. Conflict of interest: None declared.

Analisis Kepuasan Pasien Rawat Jalan Puskesmas Dringu Kabupaten Probolinggo

Dringu Public Health Center, Probolinggo Region, has a vision to become a public health center with the optimal health services. It can be known from patient satisfaction assessment. So far, the patient satisfaction assessment has never been carried out in Dringu Public Health Center. The purpose of this study was to analyze the outpatient satisfaction of the Dringu Public Health Center, Probolinggo Region, through service quality method based on five (5) service quality dimensions of tangible, reliability, responsiveness, assurance and empathy. This type of research used a quantitative method. The populations consist of 23526 peoples and the samples were 100 respondents. The sampling technique used purposive sampling. Data were collected by questionnaire. The results showed that the percentage of services in tangible dimension were 86.3% of patient satisfaction and 13.7% of patient dissatisfaction. The percentage of services in reliability dimension were 89.6% of patient satisfaction and 10.4% of patient dissatisfaction. The percentage of services in responsiveness dimension were 69.7% of patient satisfaction and 30.3% of patient dissatisfaction. The percentage of services in the assurance dimension were 68.2% of patient satisfaction and 31.8% of patient dissatisfaction. In the empathy dimension, the percentage of service were 74.1% of patient satisfaction and 25.9% of patient dissatisfaction. It is recommended to create a patient admission flow as well as create a service schedule poster for Dringu public health center.

Perceptions of underlying practice hierarchies: Who is managing my care?

BackgroundThe introduction of new health professional roles, such as that of the nurse practitioner and pharmacist prescriber in primary health care can lead to changes in health service delivery. Consumers, having used these roles, often report high satisfaction. However, there is limited knowledge of how these individuals position nurse practitioner and pharmacist prescriber roles within existing practice structures.MethodsSemi-structured interviews were conducted with 21 individuals receiving services from these practitioners in New Zealand primary health care. Interviews were recorded and transcribed verbatim for thematic analysis.ResultsParticipant views reflect established practice hierarchies, placing advanced practitioners ‘below’ general practitioners. Participants are unable to articulate what it was about these practitioners that meant they operated at lower tiers and often considered practitioners to act as ‘their doctor’. They also highlight structural barriers impairing the ability of these providers to operate within their full scope of practice.ConclusionsWhile seeing value in the services they receive, consumers are often unable to position nurse practitioner and pharmacist prescriber roles within health system contexts or to articulate how they value their practitioner’s skills. Embedded structural barriers may be more visible to consumers than their interactions with the health system suggest. This may influence peoples’ ability to receive intended or optimal health services. Consumer ‘health professional literacy’ around the functions of distinct health practitioners should be supported so that they may make informed service provision choices.

Primary healthcare teams - an optimal health service for persons with intellectual disabilities?

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

HUBUNGAN PENGETAHUAN DAN RIWAYAT PENYAKIT DENGAN KELAHIRAN PREMATUR DI RUMAH SAKIT UMUM DAERAH KOTA PADANGSIDIMPUAN

The World Health Organization (WHO) reports that every year 13 million babies are born prematurely worldwide and one million babies die. The results of the 2013 Basic Health Research (Riskesdas) showed that 32.4% of infant deaths aged 0-6 days were caused by prematurity. Premature incidence in Padangsidimpuan City Hospital continues to increase from 2011-2014. The purpose of this study was to determine the relationship between knowledge and history of disease with premature birth at the Padangsidimpuan City General Hospital. This type of research is an analytic study with a cross sectional approach. The population was all mothers who gave birth prematurely and not prematurely at the Padangsidimpuan City Hospital. The sample in this study was the entire population of 92 people. The sample in this study amounted to 92 people. Data were collected through medical records and interviews using a questionnaire. Data were analyzed by univariate, bivariate using Chi-Square test at 95% confidence level (P < 0.05). The results showed that there was a relationship between medical history (p= 0.0001) and preterm birth, while the knowledge variable (p=0.061) was not related to preterm birth. It is recommended for health workers to further optimize health services by conducting antenatal care examinations according to standards to determine blood pressure, Hb levels, blood glucose in the prevention of preeclampsia, anemia, diabetes mellitus which can be at risk of prematurity. Padangsidimpuan City Hospital is expected to improve health counseling to mothers about a good age for pregnancy and childbirth, namely at the age of 20-34 years. The health office is expected to develop an atmosphere for community groups through perwiritan in socializing about prematurity

Understanding community member and health care professional perspectives on gender-affirming care-A qualitative study.

Transgender and gender diverse (TGD) people experience significant barriers to accessing affirming health services. There is a paucity of literature examining how both community members and health care professionals (HCPs) understand potential causes and solutions for these barriers, particularly in non-urban settings. We present the first systematic examination of perspectives from community members and HCPs regarding barriers to and solutions for promoting access to gender-affirming health care. Study activities were conducted through the Plan and Act for Transgender Health (PATH) Project, a health needs assessment of TGD people. Community members in the catchment area were recruited to participate in focus group discussions about access to gender-affirming health care and optimal health service delivery models in March-October 2019. HCPs were recruited to participate in focus group discussions or in-depth interviews about experiences working with TGD clients. Data were analyzed using an inductive grounded theory approach. 25 rural counties in Massachusetts, New York, Connecticut, Vermont, and New Hampshire. Study participants included 61 adult TGD community members and 23 HCPs working in the catchment area. Both community members and HCPs spoke of the need for connectedness and linkages among disparate health system components for gender-affirming health care. Participants expressed this priority through calls for systems-level improvements within existing services (e.g., expanded data collection, expanded mental health services, inclusive and affirming health care environments, and TGD staff). They also expressed the need for expanded TGD community outreach and engagement (e.g., incorporation of a patient feedback process, TGD health navigators, and resource mapping). Findings specifically reflect the perspectives of community members and HCPs in the rural New England area. Furthermore, the study sample was predominantly White non-Hispanic. Interventions to achieve accessible gender-affirming health care must address the diverse perspectives and needs of both community members and HCPs.

TRAINING PROCESSING HERBAL PLANTS TO INCREASE APPLICATION AND IMMUNITY TO CHILDREN IN THE COVID-19 PANDEMIC

The COVID-19 pandemic has had a very negative impact on various sectors, as well as on the health sector. These include nutrition and maternal and child health services. The COVID-19 pandemic has the potential to hinder the access of mothers and children to optimal health services. The decrease in the number of visits to nutrition and Maternal and Child Health (KIA) services has the potential to create new nutrition and health problems. In an effort to fulfill the need for information and health services for school-age children and adolescents in the midst of minimizing the transmission of COVID-19, various adjustments to programs and activities related to their health are needed, one of which is training to make food made from herbal plants to increase appetite as well as immunity in children. The method used is training demonstrating the processing of herbal plants into delicious food for children to consume. The targets were PKK women, residents of the herbal village, Nginden Jangungan Village, Surabaya City, which was attended by 25 PKK women. This activity will be held on June 21-19 July 2021.The results obtained from the training of the Community Training Program increase public knowledge about herbal plant processing, increase appetite and immunity in children. Increase RT/RW community-based activities to jointly develop the use of herbal plants. Conclusion Herbal plants can be processed into food products with many benefits, such as temulawak pudding which increases immunity and appetite in children.

Incidence of Nosocomial Urinary Tract Infections and Antibiotic Susceptibility Pattern of Uropathogenic Bacterial Isolates of Patients from Selected Hospitals in Nsukka, Nigeria

Urinary Tract Infection (UTI) is one of the significant healthcare and hygienic-based diseases ravaging millions of people, especially in third world countries with poor hospital settings. This cross-sectional and laboratory investigation was done to determine the incidence of nosocomial urinary tract infections (NUTIs) and antibiotic susceptibility pattern of the uropathogenic bacterial isolates from hospital patients in Nsukka, Southeastern Nigeria. Urine specimens of fifty patients were collected and analyzed between May and June 2018. Kirby-Bauer disk diffusion method was used for detection of antibiotic susceptibility pattern for all isolates. Bacteriuria was observed in urine specimens of 31 (62%) out of the 50 participants, with the specimens of 13 yielding significant growth at 42% rate of nosocomial urinary tract infections (NUTIs). The most predominant bacterial isolate of urinary tract infection was Staphylococcus spp. (31%); followed by Escherichia, Klebsiella and Proteus with (23%) each. Isolates were mostly susceptible to Ciprofloxacin (87.1%), while other isolates were mainly resistant to Zinnacef (937%). Pertinent recommendations were made with respect to treatment, multidrug resistance mitigation and aseptic and optimal health services delivery practices.

The Effect of Knowledge Management in Healthcare Services: A Systematic Review

The quality of service at health facilities needs to be improved, one of the main keys is the service provided by health workers. The aim of this systematic review was to analyze the effectiveness of knowledge management in healthcare. The systematic review was carried out in March-April 2020 with a range of article search times from 2016-2020 using 5 electronic databases (Scopus, PubMed, Science Direct, CINAHL and ProQuest). The Center for Review and Dissemination and the Joanna Briggs Institute Guideline were used to assess the quality and PRISMA's checklist for this review guide. The literature search described four keyword groups based on Medical Subject Heading (MeSH) and the search description was (knowledge management*' OR 'SECI knowledge management') AND ('health care' OR hospital). The article searched was found 13 articles suitable with the eligibility criteria, the results of the systematic review found that knowledge management had the effectiveness to provide information and knowledge processes, improve decision-making abilities, improve performance and quality of health services and increase organizational effectiveness. As health service providers, hospitals and other health care institutions must continue to improve the quality of services. By improving the quality of services, it is expected to be able to answer the demands of the community to always provide optimal health services. With the application of good knowledge management, ideas and creativity from the workforce will be created in creating health service innovations.

Job Satisfaction is Dominant Factor Influencing of Nurse Performance in X Hospital Pekanbaru

Introduction: The provision of optimal health services is determined by the quality of health workers. The research objective was to explore the factors that influence the performance of nurses in health service.Method: It was a quantitative analytic study with a cross-sectional design. A total of 58 nurses participated with a purposive random sampling technique. The data was collected by questionnaire and worksheets observation. The statistical analysis was done by Smart PLS (Partial Least Square).Result: This study showed that individual characteristics are correlated to job satisfaction (p-value 0.001) but not correlated with the performance of nurses (p-value 0.468). Organizational factors were correlated to job satisfaction (p-value 0.000) but not correlated to work performance (p-value 0.865). Job satisfaction was correlated to work performance (p-value 0.001). There was a negative correlation between individual characteristics and nurse performance (-0.466). Meanwhile, the organizational factor only has a direct effect of 0.025 on nurse performance. Only job satisfaction has a direct effect on nurse performance with an increase of 0.5 (50%) for every increase of one value of job satisfaction.Conclusion: Job satisfaction is a dominant factor that has a direct effect on nurse performance. Hospital management needs to consider health workforce planning, mapping, and development competency to optimize nurse performance.

SINERGI HALODOC DALAM MUTU PELAYANAN RUMAH SAKIT DI MASA PANDEMI COVID 19

One of the developments in information system technology in the health sector via the internet is E-health. The Medical Teleconsultation solution offered is very helpful for the Indonesian health system in screening patients with a risk of Covid 19. Halodoc is the number 1 health application in Indonesia. The purpose of this study was to determine the Halodoc synergy in the quality of hospital services on patient satisfaction, trust, and loyalty. This research was conducted in a type c hospital in collaboration with Halodoc in Denpasar, namely Surya Husada Hospital and Bali Royal Hospital. Taken a sample of 50 respondents at each hospital. Data collection techniques using a questionnaire. This study uses data analysis methods using Smart PLS software. The results of this study were Halodoc Medical teleconsultation proved to have a positive and significant effect on patient satisfaction, patient confidence and patient loyalty. The quality of hospital services is proven to have a positive and significant effect on patient satisfaction and patient confidence. Halodoc Medical Teleconsultation proved to have a positive and significant effect on the quality of hospital services. Related to the research results, it was found that some people still trust their health fully by consulting directly with medical personnel at the hospital. This research will become an illustration to see the development of medical teleconsultation in Indonesia. As well as indirectly seeing to what extent the role of Halodoc Medical Telecosultation is able to provide optimal health services in the midst of the Covid 19 pandemic.

THE EFFECT OF ECONOMIC GROWTH, UNEMPLOYMENT RATE AND HUMAN DEVELOPMENT ON POVERTY IN INDONESIA (Panel Model Approach in 4 Poorest Provinces)

The implementation of various policies in poverty alleviation in Indonesia has yielded good results. This condition is reflected by the downward trend in the percentage of poor people who reached a single digit in 2018. However, this has not much-changed the conditions in some of the poorest provinces such as Maluku, East Nusa Tenggara, West Papua, and Papua. This study aims to analyze the effect of Economic Growth, Unemployment Rate, and Human Development Index (HDI) on poverty in the four poorest provinces from 2011 to 2018. The research data sources from Statistics Indonesia (BPS) with the analytical tool used in estimating the panel data regression model is the Fixed Effect Model (FEM). The results show that economic growth and HDI have a negative effect on the poverty. In reverse, the Unemployment Rate has an insignificant effect. Based on the research results, the government advised coordinating with relevant stakeholders in formulating policies to increase welfare and purchasing power, improve the quality of education, and optimize health services in the four poorest provinces.

PEMENUHAN HAK KESEHATAN BAGI NARAPIDANA DI RUMAH TAHANAN NEGARA KELAS II B KEBUMEN

Narapidana adalah terpidana yang menjalani pidana hilang kemerdekaan di lembaga pemasyarakatan. Oleh karena itu Pemerintah melalui Direktorat Jenderal Pemasyarakatan wajib menjamin terpenuhinya hak-hak mereka yang lain, salah satunya adalah hak untuk mendapatkan pelayanan kesehatan yang optimal baik secara fisik, mental, spiritual maupun sosial. Penelitian ini bertujuan untuk mengetahui dan menjelaskan pemenuhan hak kesehatan bagi narapidana di Rumah Tahanan Negara Kelas II B Kebumen serta kendala apa saja yang muncul dalam pemenuhan hak kesehatan narapidana tersebut. Jenis penelitian ini adalah penelitian hukum dengan pendekatan yuridis empiris atau penelitian hukum sosiologis. Adapun teknik pengumpulan data dilakukan melalui penelitian lapangan dan kepustakaan dengan teknik analisis data kualitatif. Berdasarkan hasil penelitian diketahui bahwa pemenuhan hak kesehatan narapidana dilakukan dengan berpedoman pada peraturan perundang-undangan yang berlaku seperti pemberian penyuluhan kesehatan dan merujuk narapidana yang menderita sakit serius ke rumah sakit. Kemudian kendala yang muncul dalam pemenuhan hak kesehatan narapidana adalah keterbatasan tenaga kesehatan, minimnya sarana dan prasarana kesehatan, dan kondisi rutan yang mengalami overkapasitas. Solusinya adalah peningkatan kualitas dan kemampuan pegawai, serta penambahan fasilitas kesehatan dan ruang klinik yang memadai.

Self-Diagnosis of Web-Based Pregnancy and Childbirth Disorders Using Forward Chaining Methods

The high mortality rate for pregnant women and childbirth in Bali, Indonesia, is caused by a lack of initial diagnosis of the diseases and complaints experienced by pregnant women during pregnancy, as well as a lack of health medical personnel scattered throughout Bali, to be able to provide optimal health services. It is necessary to have an online information system that helps pregnant women to be able to independently and online diagnose diseases, complaints, and symptoms experienced during pregnancy. The system must be able to be accessed anytime and anywhere, with high reliability and availability, and provide fast diagnostic results. Focus of this research is design and implementation of an Information System for Diagnosis of Pregnancy Disorders Based on Cloud Computing based on Forward Chaining Method, using Design Science Research Methodology (DSRM) and tested using the Technology Acceptance Model (TAM) method. The application is placed on the Hybrid Cloud. The results of this research, can help pregnant women in diagnosing diseases and complaints online, to reduce the mortality rate for pregnant women and giving birth.

Analisis Pengaruh Umur, Paritas, dan Motivasi Suami terhadap Nyeri Persalinan di Cirebon Tahun 2019

Background : Mothers who experience childbirth will feel pain. Labor pain is an unpleasant sensory and emotional experience due to tissue damage. In Indonesia Health Profile Data in 2018, there are 4643 Health Centers that work together through the health departement with blood transfusion units and hospitals in blood services to reduce maternal mortality. It is an effort of the health service the it is also necessary en effort from the family, especially the husband. Other factors need to be assessed for what affects labor pain. In 2015, maternal mortality rate especially in Cirebon, is 4 people on 5409 live birth. So, in this study will be seen again which factors that influence labor pain. Objective : Literature studies and preliminary studies were conducted to further examine and describe the experience of mothers through childbirth in Cirebon. Method : The design of this research is descriptive research. In this study, an analysis will be conducted, namely analysis of the influence, age, parity and motivation of husbands on the healing of special births in Cirebon District, which will be carried out using descriptive methods in which the data collection process allows the research to produce a description related to this study. The sampling technique in this research is criterion-based selection sampling, because the sample selection is based on certain unique criteria.Result and Discussion : The results of the study are there are 5 categories such as husband character husband’s treatment when the mother is giving birth, number of children, husband’s motivation and back massage from husband. From 10 informans, 7 primigravida with an average age of 28 years, in her experience felt very experiencing labor pain even though her husband provided motivation without treatment during the process of giving birth. The character of multigravida mothers as informan 3,4,and 5. They are on average 36 years old., 2 informans stated, they didn’t not feel pain because their husbands motivated and facilitated pain managements like back massage. Conclusion : The conclusion of this research is that all health workers who focus on reproductive health, to be more pro active in facilitating mothers who will give birth. Then matenity women, especially in Cirebon better get the assistance of their husband and family as applying the theory of family center maternity care. The outcome of this study is related to the Cirebon District Health Office's mission, which is to improve the ability, quality and professionalism of the health provider, optimize health services to the community, and create a healthy community.

Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions.

Burnout is a major occupational problem among healthcare providers, especially during the Covid-19 pandemic. The frontline health workforce is experiencing a high workload and multiple psychosocial stressors which may affect their mental and emotional health, leading to burnout symptoms. Moreover, sleep deprivation and a critical lack of psychosocial support may aggravate such symptoms amidst Covid-19. From an ethical viewpoint, healthcare providers may experience moral distress while safeguarding patient welfare and autonomy. Moreover, social injustice and structural inequities may affect their emotional health while tackling a high volume of new cases and mortality. Global evidence indicates the need for adopting multipronged evidence-based approaches to address burnout during this pandemic, which may include increasing the awareness of work-related stress and burnout, promoting mindfulness and self-care practices for promoting mental wellbeing, ensuring optimal mental health services, using digital technologies to address workplace stress and deliver mental health interventions, and improving organisational policies and practices focusing on burnout among healthcare providers.

Evaluasi Pelayanan Kesehatan Jiwa Berbasis Komunitas Di Kota Palembang

The concept of complete mental health efforts is the handling of health problems and its foundation includes community mental health efforts, supported by basic mental health services and strengthened integrated referral mental health services. Most of ODGJ have not gotten health care. Not yet optimal mental health services indirectly affect the success rate of health development. This research aims to analyse the implementation of community-based mental health services in Palembang. Methods of research with qualitative design, informant in the research is chosen purposive. Data retrieval techniques with in-depth interviews to 12 informant, observation and study of documents. Triangulation is done in the form of triangulation of source, method and data. Results showed that the low public awareness of mental health is still low because of the high level of negative stigma of society and low public knowledge that can impact on the support that will be provided by Family. So the empowerment of community needs to reach people to access mental health services. This research suggests that there is a proactive stance from the public health center to reach people throughout their workforce by reproducing activities outside the public health center, strengthening cross-sector cooperation and empowering community.

Analysis of Factors Affecting the Skills of Nurses in Installation of Infuses at Mitra Medika Amplas Hospital

Nurses are one of the most decisive factors in achieving optimal health services with quality nursing care. The quality of good health services can be seen from the facilities, technology, physical appearance, and behaviour of employees which must reflect high professionalism and commitment. Patient complaints related to the infusion by nurses at Mitra Medika Amplas Hospital are still common. The research objective was to analyze the factors affecting the skills of nurses in the infusion set up at Mitra Medika Hospital Amplas. The research design used an analytic survey with a cross-sectional design. The study population of all nurses who work in outpatient and inpatient rooms were 190 people. The sampling technique used cluster random sampling. The number of samples to be studied was 100 respondents. Data analysis was performed by univariate, bivariate, and multivariate analyses. The results of the research variable knowledge obtained p-value = .04, attitude 1.0, leadership .53, work design structure .209, experience .166, and 1.0 career path. The p-value of knowledge <.05 means that the influence between knowledge and skills of nurses in infusion found. The variable attitude, leadership, work design structure, experience, and career path p-value >.05 means the influence between the knowledge and skills of nurses in infusion not found. Based on 6 variables tested, only the knowledge factor that had an influence on the skills of nurses in the infusion. It is recommended for health workers to always carry out nursing care based on the applicable SPO, for further researchers it is recommended to examine other factors.

Syndemic profiles of people living with hepatitis C virus using population-level latent class analysis to optimize health services

BackgroundHepatitis C (HCV) affects diverse populations such as people who inject drugs (PWID), 'baby boomers,’ gay/bisexual men who have sex with men (gbMSM), and people from HCV endemic regions. Assessing HCV syndemics (i.e.relationships with mental health/chronic diseases) among subpopulations using Latent Class Analysis (LCA) may facilitate targeted program planning. MethodsThe BC Hepatitis Testers Cohort(BC-HTC) includes all HCV cases identified in BC between 1990 and 2015, integrated with medical administrative data. LCA grouped all BC-HTC HCV diagnosed people(n = 73,665) by socio-demographic/clinical indicators previously determined to be relevant for HCV outcomes. The final model was chosen based on fit statistics, epidemiological meaningfulness, and posterior probability. Classes were named by most defining characteristics. ResultsThe six-class model was the best fit and had the following names and characteristics:‘Younger PWID’(n =11,563): recent IDU (67%), people born >1974 (48%), mental illness (62%), material deprivation (59%).‘Older PWID’(n =15,266): past IDU (78%), HIV (17%), HBV (17%) coinfections, alcohol misuse(68%).‘Other Middle-Aged People’(n = 9019): gbMSM (26%), material privilege (31%), people born between 1965−1974 (47%).‘People of Asian backgrounds’ (n = 4718): East/South Asians (92%), no alcohol misuse (97%) or mental illness (93%), people born <1945 (26%), social privilege (66%).‘Rural baby boomers’ (n = 20,401): rural dwellers (32%), baby boomers (79%), heterosexuals (99%), no HIV (100%).‘Urban socially deprived baby boomers’ (n = 12,698): urban dwellers (99%), no IDU (100%), liver disease (22%), social deprivation (94%). ConclusionsDifferences between classes suggest variability in patients’ service needs. Further analysis of health service utilization patterns may inform optimal service layout.