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Liang S, Chen Z, Tang W, Andarini E, Kou L, Li Y, Cai W. Prevalence and predictors of help-seeking behavior among post-partum women with urinary incontinence in China and Indonesia: A cross-sectional survey based on Andersen Help-Seeking Model. Midwifery 2024; 128:103885. [PMID: 37984080 DOI: 10.1016/j.midw.2023.103885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Urinary incontinence (UI) is a prevalent condition among post-partum women, and it can significantly affect their physical and psychosocial well-being. Therefore, it's crucial for post-partum women to discuss any UI symptoms they may be experiencing with their healthcare provider and seek appropriate treatment. PURPOSE To investigate what leads post-partum women with UI to seek help in China and Indonesia based on the Andersen Help-Seeking Model. METHODS A cross-sectional digital survey among post-partum women (6 weeks to 1 year) was conducted from May to November 2021 in China and Indonesia. The survey contents included: (1) demographic characteristics, (2) social support, (3) health care needs, (4) capacity and resources. For analysis, descriptive statistics, independent sample t-tests and chi-square tests were used to determine the differences between help-seeking and non-help-seeking women with UI, and logistic regression analysis and the receiver operating characteristic curve (ROC) was used to determine the predictors of heal-seeking behavior in post-partum women with UI. RESULTS The prevalence of UI was 25 % (215/868) and 31 % (187/605) among post-partum women in China and Indonesia. Among post-partum women with UI, the help-seeking rate was 46 % (98/215) and 52 % (98/187) in China and Indonesia. Incontinence quality of Life, support from women of the family (Yes), knowing the available department for UI (Yes), current knowledge of UI and the current status of UI were independent risk factors for China (P<0.05). Support from husband (Yes), being asked about UI by a doctor (Yes) and the current status of UI were independent risk factors for Indonesia. The obtained area under ROC curve (AUC) for the model were 0.884 and 0.935 in China and Indonesia. CONCLUSIONS The prevalence of UI and the rate of seeking help for UI in Indonesia were higher than those in China. Social support, needs and the availability of resources and organizational support to assist patients in their help-seeking efforts, were the main predictors affecting help-seeking behavior among post-partum women with UI.
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Affiliation(s)
- Surui Liang
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Zhaoying Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Wenjun Tang
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Esti Andarini
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Lin Kou
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Wenzhi Cai
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
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Hayashi K, Miki K, Ikemoto T, Ushida T, Shiro Y, Tetsunaga T, Takasusuki T, Hosoi M, Yukioka M. Predictors of high-cost patients with acute whiplash-associated disorder in Japan. PLoS One 2023; 18:e0287676. [PMID: 37379284 DOI: 10.1371/journal.pone.0287676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/12/2023] [Indexed: 06/30/2023] Open
Abstract
INTRODUCTION The proportion of neck injuries due to traffic accidents is increasing. Little is known about high-cost patients with acute whiplash-associated disorder (WAD). The present study aimed to investigate whether time to first visit for conventional medicine, multiple doctor visits, or alternative medicine could predict high-cost patients with acute WAD in Japan. METHODS Data from a compulsory, no-fault, government automobile liability insurance agency in Japan between 2014 and 2019 were used. The primary economic outcome was the total cost of healthcare per person. Treatment-related variables were assessed based on the time to first visit for conventional and alternative medicine, multiple doctor visits, and visits for alternative medicine. Patients were categorized according to total healthcare cost (low, medium, and high cost). The variables were subjected to univariate and multivariate analysis to compare high-cost and low-cost patients. RESULTS A total of 104,911 participants with a median age of 42 years were analyzed. The median total healthcare cost per person was 67,366 yen. The cost for consecutive medicine, for consecutive and alternative medicine, and total healthcare costs were significantly associated with all clinical outcomes. Female sex, being a homemaker, a history of WAD claim, residential area, patient responsibility in a traffic accident, multiple doctor visits, and visits for alternative medicine were identified as independent predictive factors for a high cost in multivariate analysis. Multiple doctor visits and visits for alternative medicine showed large differences between groups (odds ratios 2673 and 694, respectively). Patients with multiple doctor visits and visits for alternative medicine showed a significantly high total healthcare cost per person (292,346 yen) compared to those without (53,587 yen). CONCLUSIONS A high total healthcare cost is strongly associated with multiple doctor visits and visits for alternative medicine in patients with acute WAD in Japan.
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Affiliation(s)
- Kazuhiro Hayashi
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States of America
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
| | - Kenji Miki
- Center for Pain Management, Hayaishi Hospital, Osaka, Japan
- Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan
- Department Rheumatology, Yukioka Hospital, Osaka, Japan
- Japan Pain Foundation, Tokyo, Japan
| | - Tatsunori Ikemoto
- Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Japan
| | - Takahiro Ushida
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Japan Pain Foundation, Tokyo, Japan
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Japan
| | - Yukiko Shiro
- Japan Pain Foundation, Tokyo, Japan
- Department of Pain Medicine, Aichi Medical University, Nagakute, Japan
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan
| | - Tomoko Tetsunaga
- Japan Pain Foundation, Tokyo, Japan
- Department of Orthopaedic Surgery, Okayama University, Okayama, Japan
| | - Toshifumi Takasusuki
- Japan Pain Foundation, Tokyo, Japan
- Department of Anesthesiology, Dokkyo Medical University, Mibu, Japan
| | - Masako Hosoi
- Japan Pain Foundation, Tokyo, Japan
- Department of Psychosomatic Medicine and Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Masao Yukioka
- Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan
- Department Rheumatology, Yukioka Hospital, Osaka, Japan
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Ghosal J, Dutta A, Kshatri JS, Das A, Kanungo S, Singh A, Kerketta S, Ghosal S, Kaur H, Bal M, Ranjit M, Satpathy SK, Pati S. Development, validation & pilot testing of a questionnaire to assess healthcare seeking behaviour, healthcare service utilization & out-of-pocket expenditure of Particularly Vulnerable Tribal Groups of Odisha, India. Indian J Med Res 2023; 157:412-420. [PMID: 37955217 PMCID: PMC10443718 DOI: 10.4103/ijmr.ijmr_3570_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 11/14/2023] Open
Abstract
Background & objectives Assessing healthcare seeking behaviour (HSB), healthcare utilization and related out-of-pocket expenditures of Particularly Vulnerable Tribal Groups (PVTGs) of India through a prism of the health system may help to achieve equitable health outcomes. Therefore, this comprehensive study was envisaged to examine these issues among PVTGs of Odisha, India. However, there exists no validated questionnaire to measure these variables among PVTGs. Therefore, a study questionnaire was developed for this purpose and validated. Methods Questionnaire was constructed in four phases: questionnaire development, validity assessment, pilot testing and reliability assessment. Nine domain experts face validated questionnaire in two rounds, followed by a single round of quantitative content validity. Next, the questionnaire was pretested in three rounds using cognitive interviews and pilot-tested among 335 and 100 eligible individuals for the two sections healthcare seeking behaviour (HSB-Q) and maternal and child healthcare service utilization (MCHSU-Q). Internal consistency reliability was assessed for de novo HSB-Q. Results On two rounds of expert-driven face validity, 55 items were eliminated from 200 items. Questionnaire showed moderate to high content validity (item-level content validity index range: 0.78 to 1, scale-level content validity index/universal agreement: 0.73; scale-level content validity index/average: 0.96 and multirater kappa statistics range: 0.6 to 1). During the pre-test, items were altered until saturation was achieved. Pilot testing helped to refine interview modalities. The Cronbach alpha and McDonald's omega assessing internal consistency of HSB-Q were 0.8 and 0.85, respectively. Interpretation & conclusions The questionnaire was found to be valid and reliable to explore healthcare seeking behaviour, maternal and child healthcare utilization and related out-of-pocket expenditure incurred by PVTGs of Odisha, India.
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Affiliation(s)
- Jyoti Ghosal
- Department of Public Health, School of Public Health, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Ambarish Dutta
- Department of Epidemiology, Indian Institute of Public Health, Bhubaneswar, Odisha, India
| | - Jaya Singh Kshatri
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Arundhuti Das
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Aalapti Singh
- Department of Community Medicine, Institute of Medical Sciences & SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Sushmita Kerketta
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Shishirendu Ghosal
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Harpreet Kaur
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Madhusmita Bal
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Manoranjan Ranjit
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Sudhir Kumar Satpathy
- Department of Public Health, School of Public Health, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Department of Immunology, Molecular Epidemiology & Public Health, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
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Jang S, Suh EE. Outpatient Service Use in Korean Older Adult Women with Degenerative Arthritis Based on Andersen's Model. Geriatrics (Basel) 2023; 8:geriatrics8010009. [PMID: 36648914 PMCID: PMC9844404 DOI: 10.3390/geriatrics8010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
To ensure that older adults (aged 65 years or older) can experience a healthy life, they should use medical services that are appropriate, both quantitatively and qualitatively. This study aimed to identify the factors affecting outpatient service use by older adult women with degenerative arthritis using Andersen’s model. A survey was conducted among 232 older adult women with degenerative arthritis in two university hospitals in Seoul. The Korean Activities of Daily Living, Korean Instrumental Activities of Daily Living, and the Geriatric Depression Scale Short Form were used. Data were analyzed using descriptive statistics, χ2-test, t-test, and multiple logistic regression analysis. Among the participants, 69.8% used outpatient services and 30.2% did not. In the univariate analyses, age, marital status, residency, household income, chronic diseases, subjective health status, and disability were significant. Age (odds ratio [OR] = 5.53, p < 0.001), annual household income (OR = 5.64, p < 0.001), chronic diseases (OR = 11.06, p < 0.001), and disability (OR = 3.56, p = 0.016) significantly affected outpatient service use. The results suggest that health promotion interventions for Korean older adult women should focus on predicting outpatient service use according to the patient’s characteristics.
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Affiliation(s)
- Soyoung Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Eunyoung E. Suh
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
- Correspondence: ; Tel.: +82-2-740-8484
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Jiang H, Zhao M, Tian G, Zhao Z, Ding D, Yin M. Perceived effect of financial risk protection by the Urban-Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China. BMJ Open 2021; 11:e047699. [PMID: 34667000 PMCID: PMC8527163 DOI: 10.1136/bmjopen-2020-047699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES It is to explore the perceived financial risk protection effect of the Urban-Rural Resident Basic Medical Insurance Scheme (URRBMI) and its influencing factors to provide evidence to further improve the URRBMI. DESIGN It is a cross-sectional survey. PARTICIPANTS This mixed-methods study is conducted in five provinces in rural China. Through stratified cluster random sampling, 1681 rural residents participate in a cross-sectional questionnaire survey (1657 valid questionnaires are retrieved). Thirty rural residents participate in in-depth interviews. PRIMARY AND SECONDARY OUTCOME MEASURES A multivariate logistic regression analysis is adopted to identify factors influencing respondents' perceptions. Semistructured interviews are used to identify the reasons why some respondents believed the URRBMI to be ineffective. RESULTS Overall, 77.5% of respondents believe that the URRBMI is effective. Respondents, who are older, have a higher household income, prefer primary health facilities and provide a higher rating for critical illness compensation and maximum compensatory payouts. They are more likely to give the URRBMI a higher effectiveness rating than their counterparts. Qualitatively, participants who believe the URRBMI to be ineffective list the following reasons: low outpatient service coverage, insufficient or undersupplied drugs and services in the insurance list, problems in the arrangement of deductibles and maximum compensatory payouts, provider-induced behaviour and increased healthcare service price. CONCLUSIONS This exploration focuses on the reasons why rural residents think the scheme is invalid, which are vital for policy reform. Policies should focus on benefits design and coverage, the assumption of a supervisory role, avoiding financial risk stemming from critical illness and cross-sectoral actions to strengthen the primary healthcare system and comprehensive social security wealth.
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Affiliation(s)
- Huan Jiang
- Humanities and Social Sciences College, Harbin Medical University, Harbin, China
| | - Miaomiao Zhao
- Department of health management, Shcool of public health, Nantong university, Nantong, Jiangsu,China
| | - Guomei Tian
- Fourth affiliate hospital of Harbin Medical University, Harbin, Heilongjiang,China
| | - Zihua Zhao
- Scientific Research Department, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ding Ding
- Department of Social Medicine, Dalian Medical University, Dalian, China
| | - Mei Yin
- Humanities and Social Sciences College, Harbin Medical University, Harbin, China
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Driving factors for the utilisation of healthcare services by people with osteoarthritis in Portugal: results from a nationwide population-based study. BMC Health Serv Res 2021; 21:1022. [PMID: 34583701 PMCID: PMC8479902 DOI: 10.1186/s12913-021-07045-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt, in Portugal. Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables. Results In our sample, a high proportion of participants are overweight or obese (82,6%, n = 748) and physically inactive (20,6%, n = 201) and a small proportion had physiotherapy management (14,4%, n = 141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. “GPUsers” represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations (p < 0,05) with the higher utilisation of healthcare services profiles. Conclusions Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07045-4.
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Hajek A, Bertram F, Heinrich F, van Rüth V, Ondruschka B, Kretzler B, Schüler C, Püschel K, König HH. Determinants of health care use among homeless individuals: evidence from the Hamburg survey of homeless individuals. BMC Health Serv Res 2021; 21:317. [PMID: 33827570 PMCID: PMC8026095 DOI: 10.1186/s12913-021-06314-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/22/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To identify the determinants of health care use among homeless individuals. METHODS Data were taken from the Hamburg survey of homeless individuals (n = 100 individuals in the here used model, mean age 44.8 years, SD 12.5) focusing on homeless individuals in Hamburg, Germany. The number of physician visits in the past 3 months and hospitalization in the preceding 12 months were used as outcome measures. Drawing on the Andersen model of health care use as a conceptual framework, predisposing characteristics, enabling resources and need factors as well as psychosocial variables were included as correlates. RESULTS Negative binomial regressions showed that increased physician visits were associated with being female (IRR: 4.02 [95% CI: 1.60-10.11]), absence of chronic alcohol consume (IRR: 0.26 [95% CI: 0.12-0.57]) and lower health-related quality of life (IRR: 0.97 [95% CI: 0.96-0.98]). Furthermore, logistic regressions showed that the likelihood of hospitalization was positively associated with lower age (OR: 0.93 [95% CI: 0.89-0.98]), having health insurance (OR: 8.11 [2.11-30.80]) and lower health-related quality of life (OR: 0.97 [95% CI: 0.94-0.99]). CONCLUSIONS Our study showed that predisposing characteristics (both age and sex), enabling resources (i.e., health insurance) and need factors in terms of health-related quality of life are main drivers of health care use among homeless individuals. This knowledge may assist in managing health care use.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Franziska Bertram
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victoria van Rüth
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Schüler
- Deutsches Rotes Kreuz Kreisverband Hamburg Altona und Mitte e.V, Hamburg, Germany
| | - Klaus Püschel
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Individual Capital Structure and Health Behaviors among Chinese Middle-Aged and Older Adults: A Cross-Sectional Analysis Using Bourdieu's Theory of Capitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207369. [PMID: 33050214 PMCID: PMC7599811 DOI: 10.3390/ijerph17207369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 01/06/2023]
Abstract
This study draws on Bourdieu’s theory of capitals to analyze the relative importance of economic, cultural, and social capital on health behaviors in Chinese middle-aged and older adults. Based on data from the China Family Panel Studies of 2016 (N = 15,147), we first harnessed a binary logistic regression model to discuss the associations between the three capitals and four types of health behaviors (i.e., physical exercise, smoking, binge drinking and stay-up). Using the sheaf coefficients technique, we then compared the relative effects of three of the capitals on health behaviors. The results suggest that cultural capital is the most influential one, which would significantly increase physical exercise and stay-up behaviors, and reduce smoking and binge drinking behaviors. Economic capital is also an important predictor, that may reduce smoking behavior but increase binge drinking and stay-up behaviors. Social capital has shown the least importance, although it would still be saliently associated with physical exercise, smoking and stay-up behaviors. In addition, some significant group disparities are also identified. This article is one of the first to explain health behavior inequalities through a Bourdieusian capital-based approach in Chinese contexts.
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Shebeshi DS, Dolja‐Gore X, Byles J. Estimating unplanned and planned hospitalization incidents among older Australian women aged 75 years and over: The presence of death as a competing risk. Int J Health Plann Manage 2020; 35:1219-1231. [DOI: 10.1002/hpm.3030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/21/2019] [Accepted: 06/24/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Dinberu S. Shebeshi
- Research Centre for Generational Health and Ageing (RCGHA), Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
- Centre for Clinical Epidemiology and Biostatistics University of Newcastle Newcastle Australia
- Research Assets Division SAX Institute, Level 3, 30C Wentworth Street Glebe NSW Australia
| | - Xenia Dolja‐Gore
- Research Centre for Generational Health and Ageing (RCGHA), Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing (RCGHA), Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
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Paccoud I, Nazroo J, Leist A. A Bourdieusian approach to class-related inequalities: the role of capitals and capital structure in the utilisation of healthcare services in later life. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:510-525. [PMID: 31769062 PMCID: PMC7079030 DOI: 10.1111/1467-9566.13028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This paper draws on Bourdieu's theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on healthcare service use in later life. Based on data from the fifth wave of the Survey of Health, Aging, and Retirement in Europe (n = 64,840), we first look at the contribution of each capital in the use of three healthcare services (general practitioner, dentist and hospital). Using cluster analysis, we then mobilise Bourdieu's concept of habitus to explain how the unequal distribution of material and non-material capitals acquired in childhood lead to different levels of health and hospital care utilisation in later life. After controlling for demographic and health insurance variables, our results show that economic capital has the strongest individual association among the three capitals. However, the results of a cluster analysis used to distinguish between capital structures show that those with high non-material capital and low material capital have higher levels of primary healthcare utilisation, and in turn lower levels of hospital use. Bourdieu's approach sheds light on the importance of capitals in all forms and structures to understand the class-related mechanisms that contribute to different levels of healthcare use.
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Affiliation(s)
- Ivana Paccoud
- Institute for Research on Socio‐Economic inequalities (IRSEI)University of LuxembourgLuxembourg CityLuxembourg
| | - James Nazroo
- Cathie Marsh Institute for Social ResearchUniversity of ManchesterManchesterUK
| | - Anja Leist
- Institute for Research on Socio‐Economic inequalities (IRSEI)University of LuxembourgLuxembourg CityLuxembourg
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Bascur-Castillo C, Araneda-Gatica V, Castro-Arias H, Carrasco-Portiño M, Ruiz-Cantero MT. Determinants in the process of seeking help for urinary incontinence in the Chilean health system. Int J Gynaecol Obstet 2018; 144:103-111. [PMID: 30267534 DOI: 10.1002/ijgo.12685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/24/2018] [Accepted: 09/27/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To analyze via the Andersen model what leads women with urinary incontinence (UI) to seek help and remain in the healthcare system. METHODS An interpretative phenomenologic study enrolling women aged 18 years or older who were diagnosed with UI at a tertiary care hospital in Chile between January and March 2016. Data were collected by semi-structured interview. The categories explored experience with UI and reasons for seeking health care, and included the dimensions of the Andersen model. RESULTS Ten women were enrolled. Characteristics that eased or hindered healthcare seeking were identified to come from the women (frequency and quantity of symptoms, coping strategies, and beliefs about its causes) and from their environment (reaction of partner, family, or coworkers to her condition). Some were associated with primary care (human and/or technical resources) and some with secondary care (pelvic floor units). CONCLUSION The results reflect the complexities of asking for health care for women with UI, especially in a country such as Chile with different healthcare levels. Raising awareness of this complexity and developing an approach that includes all stakeholders (institution, community, and family) is crucial for professionals who want to offer both medical therapy and wellness-focused healthcare.
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Affiliation(s)
- Carolina Bascur-Castillo
- Department of Obstetrics and Puericulture, Faculty of Medicine, University of Concepción, Concepción, Chile.,Pelvic Floor Unit, Dr. Guillermo Grant Benavente Hospital, Concepción, Chile
| | | | - Henry Castro-Arias
- Pelvic Floor Unit, Dr. Guillermo Grant Benavente Hospital, Concepción, Chile.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Concepción, Concepción, Chile
| | - Mercedes Carrasco-Portiño
- Department of Obstetrics and Puericulture, Faculty of Medicine, University of Concepción, Concepción, Chile.,Research Group on Public Health, University of Alicante, Alicante, Spain
| | - María Teresa Ruiz-Cantero
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Concepción, Concepción, Chile.,CIBER de Epidemiología y Salud Púbica, Madrid, Spain
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Hajek A, König HH. Which factors lead to frequent attendance in the outpatient sector among individuals in the second half of life? Evidence from a population-based longitudinal study in Germany. BMC Health Serv Res 2018; 18:673. [PMID: 30165847 PMCID: PMC6117977 DOI: 10.1186/s12913-018-3487-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/22/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Despite only constituting a small percentage of the population, frequent attenders place a tremendous burden on the healthcare system in Germany. Whilst there are some cross-sectional studies that examine the correlates of frequent attendance among older adults, there are only a few longitudinal studies that analyze the factors that lead to frequent attendance among middle-aged or older adults. Thus, the aim of this study was to investigate the factors leading to frequent attendance in the outpatient sector longitudinally. METHODS Data was drawn from three waves of a large, population-based sample of community-dwelling individuals aged 40 and above in Germany (n = 1049 in fixed effects regression). Individuals were classified as frequent attenders (GP visits) if they had, on average, visited a GP every second month in the previous 12 months. The same logic was applied for specialist visits. RESULTS Conditional FE logistic regressions showed that the onset of frequent attendance (GP visits) was negatively associated with age [OR: 0.91, 95% CI: 0.87-0.95], a change in employment status from employed to unemployed [OR: 2.26, 1.17-4.39], decreases in physical functioning [OR: 0.98, 0.97-0.99], worsening self-rated health [OR: 1.40, 1.11-1.78], and increases in physical illnesses [OR: 1.18, 1.06-1.32]. Similarly, the onset of frequent attendance (specialist visits) was associated with age [OR: 0.95, 0.92-0.98], decreases in physical functioning [OR: 0.99, 0.98-1.00], worsening self-rated health [OR: 1.50, 1.25-1.79], and increases in physical illnesses [OR: 1.24, 1.13-1.35]. CONCLUSIONS Need factors in particular were associated with the onset of frequent attendance. This relation did not vary by gender nor education, which may indicate that individuals only start to use health services more frequently when their needs increase.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
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