Utilization Of Health Care Services Research Articles

Baltimore oral epidemiology, disease effects, and HIV evaluation study (BEEHIVE) study protocol: a prospective cohort study

BackgroundAs antiretroviral therapy has become widely available and highly effective, HIV has evolved to a manageable, chronic disease. Despite this health advancement, people living with HIV (PLWH) are at an increased risk for age-related non-communicable diseases (NCDs) compared to HIV-uninfected individuals. Similarly, PLWH are at an increased risk for selected oral diseases. PLWH with a history of injecting drugs experience an even greater burden of disease than their counterparts. The overall objective of the Baltimore Oral Epidemiology, Disease Effects, and HIV Evaluation (BEEHIVE) study is to determine the combined effects of HIV infection and NCDs on oral health status. The specific aims of the study are to: (1) determine to what extent HIV status influences access to and utilization of oral health care services; (2) determine to what extent HIV status affects self-reported and clinical oral health status; (3) determine to what extent HIV status influences the progression of periodontitis; and (4) determine to what extent HIV status impacts the periodontitis-associated oral microbiome signature.MethodsThe BEEHIVE study uses a prospective cohort study design to collect data from participants at baseline and at a 24-month follow-up visit. Data are collected through questionnaire assessments, clinical examinations, and evaluation of oral microbiological samples to determine the drivers of oral disease among a high-risk population of PLWH with a history of injection drug use and prevalent comorbid NCDs. The established AIDS Linked to the Intravenous Experience (ALIVE) cohort serves as the source of participants for the BEEHIVE Study.DiscussionUpon completion of the BEEHIVE study, the knowledge gained will be important in informing future clinical and preventive interventions that can be implemented into medical and dental practice to ultimately help eliminate long-standing oral health inequities that PLWH experience.

Institutional practices for charitable medication access for uninsured patients.

To identify the most frequently prescribed medications, the location where prescriptions were filled, and whether a voucher was utilized among patients enrolled in a charitable care program within an academic medicalcenter. This was a retrospective cohort study analyzing electronic health record and pharmacy dispensing information at a medical center's outpatient pharmacies. Patients included in this analysis were enrolled in a charitable care program and had at least 1 ambulatory encounter in a primary care clinic from March 1, 2019, to June 30, 2021. The study identified frequently prescribed medications, prescription payment methods, the overall cost of prescriptions if available, and the percentage of patients who filled their prescription at a medical center's outpatient pharmacies vs external outpatient pharmacies. Descriptive statistics were used to describe the results. This study included 511 patients, 87% of whom were Spanish speaking. A total of 8453 prescriptions were identified, and more than half of the prescriptions were sent to external outpatient pharmacies. The most common medications prescribed were for cardiovascular disease, diabetes, and pain treatment. Forty-seven percent of all prescriptions were sent to the medical center's outpatient pharmacies. The medical center's charitable care program covered the costs of 44% of the prescriptions sent to internal pharmacies, assisting 148 unique patients and incurring a cost of $111,052 for the medical center. Overall, this study was able to characterize patient demographics, historical costs related to charitable care coverage, and the utilization of health care services among this population. This information can be used to support the development and implementation of a charitable medication formulary, with the aims of improving quality of care for this population and reducing medical center costs.

Orchestrating Care: A Grounded Theory Study of Family Caregiving for Older Adults in Rural Areas.

Family caregivers provide the majority of long-term care and support of older adults as they age or approach the end of life. Studies often refer to family caregivers as invisible because the American healthcare system, public policy, and society do not support or recognize their work. Family caregivers who provide care to older adults who live in rural areas face unique challenges due to the rural environment. The purpose of this study was to inductively develop a theoretical framework that explains the process of family caregiving to older adults who live at home in rural areas and require daily assistance while exploring their experiences regarding access, utilization, challenges, and effectiveness of patient healthcare services and caregiver resources in rural areas. The grounded theory method of Strauss and Corbin was used for sampling, data collection, and data analysis. Fifteen family caregivers who oversaw and/or provided care on a daily basis to an older adult living in two rural counties of New York State participated in the study. Data were collected through two semi-structured interviews with each participant, yielding 30 interviews. Findings revealed that family caregivers engaged in the process of orchestrating care by growing into caregiving, integrating technology, and utilizing networks when providing and managing caregiving. Understanding caregiving from the perspective of family caregivers engaged in the process can inform healthcare practice, healthcare education, and public policy and can support better outcomes for both older adults and their family caregivers.

The Effect of Coordinating the Outpatient Treatment across Medical Specialities for Patients With Multimorbidity.

Patients with multimorbidity attend multiple outpatient clinics. We assessed the effects on hospital use of scheduling several outpatient appointments to same-day visits in a multidisciplinary outpatient pathway (MOP). This study used a quasi-experimental design. Eligible patients had multimorbidity, were aged ≥18 years and attended ≥2 outpatient clinics in five different specialties. Patients were identified through forthcoming appointments from August 2018 to March 2020 and divided into intervention group (alignment of appointments) and comparison group (no alignment). We used patient questionnaires and paired analyses to study care integration and treatment burden. Using negative binomial regression, we estimated healthcare utilisation as incidence rates ratios (IRRs) at one year before and one year after baseline for both groups and compared IRR ratios (IRRRs). Intervention patients had a 19% reduction in hospital visits (IRRR: 0.81, 95% CI: 0.70-0.96) and a 17% reduction in blood samples (IRRR: 0.83, 0.73-0.96) compared to comparison patients. No effects were found for care integration, treatment burden, outpatient contacts, terminated outpatient trajectories, hospital admissions, days of admission or GP contacts. The MOP seemed to reduce the number of hospital visits and blood samples. These results should be further investigated in studies exploring the coordination of outpatient care for multimorbidity. Can an intervention of coordinating outpatient appointments to same-day visits combined with a multidisciplinary conference influence the utilisation of healthcare services and the patient-assessed integration of healthcare services and treatment burden among patients with multimorbidity?

Effects of a Digital Therapeutic Adjunct to Eating Disorder Treatment on Healthcare Service Utilization and Clinical Outcomes: A Retrospective Analysis Using Electronic Health Records (Preprint)

Effects of a Digital Therapeutic Adjunct to Eating Disorder Treatment on Healthcare Service Utilization and Clinical Outcomes: A Retrospective Analysis Using Electronic Health Records (Preprint)

Accessibility andutilization of maternal and child health services among mothers in rural and urban communities of Oyo State

Background: Utilization of maternal and child health services has been linked to the characteristics of the health delivery system like the geographical and economic accessibility (cost) of these services. Low utilization of these services has been implicated in the explanation of high maternal and child mortality worldwide. Early and prompt utilization of maternal and child health care services would have averted most of these deaths. This study assessed the accessibility and utilization of maternal and child health services among mothers in rural and urban communities of Oyo state.Methods: This is a comparative cross-sectional study using a mixed method (quantitative and qualitative) of data collection. A pre-tested interviewer-administered questionnaire was used to collect data from 300 respondents that were recruited using a multistage sampling technique. The qualitative data was obtained through focus group discussions (FGD) with four groups selected using purposive sampling. Data was analyzed using IBM SPSS version 22 at 95% significance level with a p<0.05.Results: This study showed that significant differences existed between the respondents' utilization of maternal and child health services among women of child bearing age in the rural and urban communities (p= 0.013). Few respondents in rural communities (72, 48.0%) have good utilization of maternal and child health services compared to the urban communities where more respondents (119,79.3%) have good utilization of maternal and child health services. Proximity of health facility and affordability of maternal and child health service were found to be statistically significant for respondents in the rural community. This finding is also similar to the FGD findings from the rural discussants.Conclusion: Overall good accessibility and good utilization of maternal and child health services were found to be more for respondents in the urban areas compared their counterparts in the rural communities. It is important for the government to initiate policies on health insurance to favour maternal and child health services especially in the rural communities.

IJCM_243A: Knowledge, attitude, and practice study on rabies and its prevention in Nanded city of Maharashtra

Background: Rabies is a fatal disease. One of the main obstacles in reducing the prevalence of the disease is the lack of knowledge about animal bite and measures to be taken after it. Objectives: To access the knowledge attitude and practices related to Rabies, animal bite and utilisation of health care services related to animal bite among general population in a Nanded city of Maharashtra. Methodology: A cross sectional study was conducted among the general public aged more than 18 years in Nanded city of Maharashtra. Knowledge, attitude, and practices of people were assessed using a structured questionnaire. Data was analyzed using the Statistical Package of Social Sciences (SPSS) software. Results: Out of 122 people 89.3 % believed that animal bite causes disease. 82.7% believed rabies is fatal. 79.5% believed rabies can be prevented by vaccine. 81.9 % washed their wound with soap and water while 17.2% applied turmeric or lime. Conclusion: Knowledge about Rabies among general public seems to be superficial. Majority of people are still inclined towards traditional practices

IJCM_204A: A qualitative research to identify the barriers and facilitating factors in the utilization of healthcare services by a Particularly Vulnerable Tribal Group (PVTG) in Udupi District

Background: Udupi district hosts two major Particularly Vulnerable Tribal Groups (PVTG) namely Malaikudiya and Koraga. Koraga tribes are declining in number and deprived of availability of healthcare services and accessibility to healthcare facilities. There are a lot of barriers such as lack of awareness and social stigma amalgamate the existing conditions of Koraga tribes in Udupi district. Research studies pertaining to this problem has been seldom done. Objective: We aim to explore the barriers and facilitating factors in accessing healthcare services by a Particularly Vulnerable Tribal Group (PVTG) in Udupi district. Methodology: We conducted qualitative research through 8 in-depth interviews with AMOs from PHC and CHC, ITDP staff and NGO workers, and 3 focus group discussions with community health nurses, ASHA workers, and Koraga community leaders from Udupi district. We explored the major facilitators and barriers that influence the utilization of health care services by the PVTG. Results: On the beneficiaries’ point of view, lack of awareness, distance to health facilities, poor public transportation, perceived negative behavior of hospital staff, lack of infrastructure, unwelcoming neighbourhood approaches, and economic instability were the main barriers to utilizing healthcare facilities. On the stakeholders (providers) point of view, availability of healthcare facilities, government policies and schemes and NGO activities are the facilitating factors. Conclusion: Our study highlights the barriers to utilizing health facilities; these are not always driven by factors linked to the PVTG members’ socio- economic status but also depend significantly on the quality of the health services and other contextual factors. Although the government has made efforts to improve the rural healthcare system through national-level programs, our qualitative study shows that there are a number of barriers which lessens the effectiveness of the programs to enhance the utilization of healthcare facilities by the PVTG in the study area.

The Impact of Inequality in Socioeconomic Status on Healthcare Services Utilization

The Impact of Inequality in Socioeconomic Status on Healthcare Services Utilization

Challenges Faced by Rural Health Care Providers Caring for Parkinson's Disease Patients in Neighbor Islands of Hawai'i.

When compared to their urban counterparts, rural regions have worse health outcomes and more challenges in health care access. As the only island state in the US, Hawai'i's unique geographic layout may magnify these disparities. However, there are limited publications on the impact of urban-rural disparities in health care in Hawai'i. The study team aimed to identify the challenges rural health care providers face when managing treatment of Parkinson's disease (PD), a complex disease. A self-administered survey was sent to 247 eligible providers who practiced in Hawai'i and prescribed PD medications from 2017-2019. The survey assessed: provider's comfort level in PD management; utilization and accessibility of health care services; perspective on barriers to PD care; and perspective on telemedicine. Providers were categorized into O'ahu providers (OP, urban) and neighbor island (Hawai'i, Kaua'i, and Maui) providers (NIP, rural). The final sample size was 44 providers (18% response rate). NIP were significantly less likely than OP to report access to social workers (P=.025), geriatric services (P=.001), and psychologist/psychiatrist/mental health professionals (P=.009). There were no statistical differences in: criteria used for PD diagnosis, resources utilized for PD education, and comfort in prescribing PD medications. The findings show that NIP are just as engaged and capable in providing PD care as OP. However, NIP encounter more limitations to accessibility, which can affect the quality of PD care that their rural patients receive. Further research is needed to understand how these limitations affect health-related outcomes in PD as well as other chronic diseases.

Community-based early detection of oral precancerous lesion, accessibility and utilization of oral healthcare services among Irular tribes residing at union territory of Pondicherry.

The present study was conducted to estimate the prevalence of oral carcinoma and precancerous lesion, oral healthcare seeking behaviour and identify accessible areas of tobacco cessation centres and oral healthcare facilities among Irular adult tribes residing in Pondicherry. 1. To estimate the prevalence of oral carcinomas and precancerous lesion by using toluidine blue solution. 2. To determine their oral healthcare seeking behaviour in terms of utilizing oral healthcare facilities. 3. To identify accessible tobacco cessation centres and oral healthcare centres for prevention of oral cancer. A cross-sectional study is designed to identify oral carcinomas, oral health-care seeking behaviour among Irular tribes of Pondicherry. 1% toluidine blue solution prepared for detection of oral precancerous lesion. Data was collected using a questionnaire and clinical examination. The collected data was subjected to statistical analysis. Out of 587 study population, oral mucosal lesion among the study population was 46 (7.8%) leukoplakia and 18 (3.1%) candidiasis. Positive health seeking behaviour 24 (41.7%) was observed. The study concluded that low prevalence of oral precancerous lesion and oral healthcare seeking behaviour is poor.

Perceived Impact of COVID-19 and Strategies for effective Implementation of Maternal and Child Health Care Services in Ethiopia: A Qualitative Study

The COVID-19 pandemic has caused an abrupt reduction in the use of in-person health care. Children and women of reproductive age groups might be disproportionately affected by the disruption of routine health services, particularly in low and middle-income countries (LMICs). The aim of this study was to see the potential effects of the COVID-19 pandemic on maternal and child health (MCH) care service utilization and strategies for effective service implementation. A phenomenological qualitative inquiry was used. For the collection of the data, an in-depth interview was employed among women and informants from all levels of the health system including the health development army in July and September 2020. The data were analyzed thematically using framework analysis. The study identified a range of COVID-19 impacts on maternal and child health service utilization in Ethiopia. Namely, reduction in accessibility and quality of routine health services, low maternal and child health service utilization, challenges in the commitment of health workers, shortage in the supply of routine resources for maternal and child health services; and enduring strategies designed for effective maternal and child health service implementation. The impact of the COVID-19 pandemic on maternal and child health service utilization was identified in a clear thematic area. The findings of this study provide evidence on bases at the local level; will help the policymakers and local administrators to develop strategies for early preparedness in the context of pandemics.

Micro Level Analysis on Health Insurance Enrolment among Selected Women in Ghana: Barriers and Predictors

Background: The enrolment onto a health insurance scheme is a viable means of improving access and utilisation of healthcare services which play critical roles in efforts to attain universal health coverage in most countries for which Ghana is inclusive. However, at the micro level, there appears to be inequitable patterns of health insurance enrolment based on gender, and contextual factors. To account for these disparities, the Micro Indicator Cluster Survey (MICS) 2017/2018 was conducted to investigate, inter alia, women enrolment on national health insurance services, and the reasons behind non-enrolment of women in the reproductive ages on health insurance schemes. Thus, this paper explores the barriers and predictors of health insurance enrolment in Ghana using data obtained from a nationality representative micro indicator cluster survey. Methods: Based on health insurance enrolment trajectories, this paper comprehensively investigates the predictors of health insurance enrolment at the micro level among 9,533 women between the ages of 15 years to 49 years in Ghana using data from MICS 2017/2018 which was made available for public access in 2020. Specific items relating to health insurance enrolment which is the independent variable, and contextual and compositions factors were selected in line with relevant literature as predictors to conduct an ordinal logistic regression analysis. Findings: The findings revealed that lack of money or funds, perceived irrelevance of the scheme, relative far proximity to registration centres, and lack of confidence in the operation of health insurance services accounted for the major barriers to non-enrolment. In all, the parameters under wealth index quintile were the most significant predictors of health insurance enrolment in this study. The poorest wealth quintile exhibited the highest odd ratio of 4.655 with lower bound value of 3.873 and an upper bound of 5.595 at p value of <0.001. In sum, the higher odd ratios and statistically significant values in wealth quintile index, education, pregnancy status, and regional location demonstrate the spatial-demographic disparities in enrolment among respondents which lead to exclusion of the most vulnerable in health insurance coverage, and thus, limit the realization of its objective to provide pre-payment arrangement to cater for healthcare cost and reduce financial burden among individuals and households. Conclusion: It is concluded that at the micro level, access to health insurance services is likely to be impeded by system level factors and compositional attributes. There is the need for extensive subscriber segmentation and targeting to help address the challenges of people who are in most need of health insurance services. The national health insurance system should strengthen its pro-poor enrolment incentives and build synergies to derive support from relevant government and non-state actors to improve education and livelihood opportunities for women across the country.

Utilization and Satisfaction of Community-based Health Care Services among Older Adults

The COVID-19 pandemic has a significant impact on the capacity of health systems to continue to provide critical services. As healthcare systems around the world face a growing demand for care for patients with COVID-19, it is vital to maintain preventive and curative services, especially for the most vulnerable populations, the elderly and the elderly living with chronic diseases. The purpose of this study was to determine the level of health service utilization and satisfaction of older adults amidst COVID-19 pandemic. The study used a descriptive- correlational research design that was conducted in a selected barangay in the city of Caloocan. The purposive and snowball sampling method was used to select respondents and must meet the following criteria: elderly between the ages of 60 and 74, and using health care services. The data collection was carried out through a series of questionnaires with an informed consent form through online platforms. Based from the data gathered, the strength of the relationship is indicated by the correlation coefficient with a score of. 795, which is greater than 0.70 shows a high correlation between the two variables. This means that when the level of utilization of community-based services of the respondent is high, their level of satisfaction with health care services increases as well. Overall, it is important to prioritize the level of utilization and satisfaction in community-based healthcare among older adults as it is used as an indicator for measuring the quality of healthcare. The level of utilization among older adults is inclined to their level of satisfaction, in which respondents are highly satisfied with their usage of services in terms of accessibility, availability and affordability of the community-based services. Moreover, demographic profile of respondents has no significant difference, which indicates that respondent’s level of satisfaction in community-based services is affected by their level of utilization of services in their barangay health center. Health services, if used by the elderly, can lead to satisfaction. Therefore, the promotion of the various health services is strongly encouraged to reach not only a few, but the whole population.

Access to Mental Healthcare Services for Black Women during Perinatal Period – A Scoping Review

BACKGROUND: Black women in Canada are at higher risk of poor mental health outcomes; this is associated with disparities such as poor access to healthcare and aggravated by racial discrimination and poor living conditions.
 
 OBJECTIVES: This study aims to investigate the extent and nature of literature on access to mental healthcare services for Black women during the perinatal period in regions outside of Africa and the Caribbean. 
 
 METHODS: We conducted a systematic article search using Medline, Cumulative Index for Nursing and Allied Health Literature (CINAHL); PsycINFO; ProQuest Public Health Database. The search strategy based on the following aspects: 1) Perinatal mental health, specifically maternal mental health 2) People of color, specifically Black people of African descent, or the African diaspora 3) Experiences with mental healthcare, specifically access and utilization. Arksey & O’Malley’s framework for conducting scoping reviews was chosen. The included studies met the following criteria: 1) articles that focused on Black Women during perinatal period living in regions outside of African and the Caribbean, 2) studies with topics related to mental health services among Black women during perinatal period. 
 
 RESULTS: n=12 articles met the inclusion criteria. The following themes were identified from the analysis of literature: 1) Disparities in utilization of mental healthcare services, 2) Spirituality, Faith, and Religion, 3) Accessibility of mental healthcare services. 
 
 CONCLUSION: There is a paucity of evidence about the mental health of prenatal and postnatal Black women living outside Africa and the Caribbean in countries other than the US, the UK, and Canada. 

Predisposing and enabling factors influencing the utilisation of maternal healthcare services at fishing landing sites in Buikwe district, Uganda

Background: Studies have demonstrated that women who get professional healthcare personnel's prenatal, delivery, and postnatal care have better pregnancy outcomes, which lowers the incidence of both neonatal and mother deaths. Uganda is among the sub-Saharan African countries with the highest percentages of maternal deaths of which the majority of the deaths take place in remote, resource-constrained areas, such as fishing landing sites. We investigated the factors influencing the use of maternity healthcare services by women from remote Lake Victoria islands fishing settlements in the Buikwe district of Uganda. Methods: A cross-sectional study design with a quantitative approach was used. One hundred and four mothers were recruited in the study carried out at Ssenyi, Kiyindi and Nkombwe landing site in Buikwe district. Questionnaires were used to obtain information from mothers about predisposing factors, and enabling factors. Multinomial logistic regression was used to determine which factors influenced the use of maternal healthcare services. Results: Marital status (p=0.045, aOR=0.582; 95% CI=0.163-2.082) and paternal occupation (p=0.017, aOR=1.335; 95% CI=0.059-8.348) were the factors influencing maternal healthcare service utilisation among the respondents. Conclusions: Increasing the amount of actions meant to raise socioeconomic standing and involving the men in maternal health seeking might aid in enhancing maternal healthcare services use by women at the landing sites in Uganda.

Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study

BackgroundThe burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents.MethodsData were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization.ResultsAccording to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently.ConclusionsGiven the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents’ access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.

Cyberchondria severity and utilization of health services in Polish society: a cross-sectional study

BackgroundIt has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents.MethodsThe analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed.ResultsCyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01–1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents.ConclusionsCyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria’s effect extends beyond health anxiety.

Comparing healthcare service utilization in insured vs. noninsured households in Rural Atsbi Womberta, Ethiopia

Community-based health insurance schemes (CBHI) in Africa are gaining attention due to high healthcare costs in developing nations, affecting 6% of individuals in extreme poverty. The World Health Organization emphasizes the need for sustainable health funding schemes to ensure access to health services. Ethiopia faces poor healthcare funding, making it one of the world's poorest nations. Tigray implemented community-based insurance as a pilot study in 69 rural communities since 2010. The objective of this study was compare differences in healthcare service utilization between community-based health insurance among insured and non-insured households in rural Atsbi-Wemberta district. A community-based comparative cross-sectional study with a qualitative approach was conducted on 172 households. Data was analyzed using SPSS, and inferential statistics were used to measure factors' association with outcome variables. A study in Kebelle revealed that the majority of respondents were female-headed, engaged in both insurance schemes, and had higher education levels. Marital status was also significant, with 89% living with their families. The majority were married, with 91.8% insured and 86.0% uninsured. Family size and income were significant factors, with high-salary households less likely to be members of the CBHI scheme. The study found that most participants considered themselves intermediate healthcare providers, with limited service due to affordability and segregation. The study suggests increasing healthcare service utilization by introducing CBHI to improve access to healthcare and promote good governance. However, the study faces criticism for unfairness and insufficient benefits for non-insured participants. Household were enrolled in CBHI (56.2%) were more probable to use health care service than households who were not enrolled (43.8%) (χ2=21.359, p<0.001). Community Benefits Insurance (CBHI) has increased healthcare utilization among insured households due to reduced illness costs and increased healthcare professional involvement. Factors like income, family size, and travel time contribute to higher utilization. However, challenges include lack of knowledge and community awareness.

A study on health care utilization and out of pocket expenditure in rural central India: A cross-sectional study

Background Out-of-pocket health expenditures have significant adverse effects, potentially resulting in impoverishment and impacting the quality of life. Awareness of patterns of healthcare utilization and out-of-pocket expenses is essential for informing healthcare scheme decisions. According to estimates from the World Health Organization in 2005, illness and the financial strain of healthcare costs force 25 million households into poverty each year. The goal of the study is to assess the proportion of households incurring out-of-pocket expenditure (OOPE) and The mean quality expended by households on healthcare. Methods In Wardha district, a cross-sectional study will be conducted. The pre-tested semi-structured survey will be administered to examine a sample of adult age groups, to identify sociodemographic data, utilization of healthcare services, and OOPE. A sample of 246 participants was selected by random sample method. Conclusion This study will help to improve and assess healthcare utilization and reduce out-of-pocket expenditures that lead to catastrophe and impoverishment. Awareness of the participants about health insurance. And they were known about the healthcare services.