The development and the utility of high-tech medical equipments are increasing relative to the health expenditure growth. These high-tech equipments do not necessary benefit the quality of patient care but increase the service utilization for hospitals. This study aims to describe the difference of equipments distribution between academic medical centers and metropolitan hospitals and to examine the association between the change of the kinds, number, and utility of high-tech medical equipments and the health service utilization. Two databases were used in this study. First, a secondary data from the annual hospital survey published in 2003 and 2004 by Taiwan Hospital Association was used. The data contained information on 8 health service volumes, kinds, number and utility of 17 kinds of high-tech medical equipments, 4 hospital characteristics, and 3 kinds of staff ratio. Second, Statistical Yearbook of Department of Social Affairs, Ministry of Interior provided data on Tthe percentage of 65+ years old population in every location. The 8 kinds of health service volumes varience were designed as dependent variables and the 3 independent variables were separately change of kinds, number and utility of high-tech medical equipments. There were 59 samples, 8 academic medical centers and 51 metropolitan hospitals, included. The t-test showed differences between academic medical centers and metropolitan hospitals in change of kinds, number, utility of high-tech medical equipments and health service volumes varience. Person correlation presented how these variables correlated to each other. Regression analyses predicted the health service utilization from those variables. Generally speaking, the academic medical centers only had significant higher varience of average daily emergency roomvisits¡]t = 3.59, p = 0.01¡^than metropolitan hospitals did but there was no significant difference in 3 independent variables. Besides, correlation among medical equipments, health service utilization and themselves shows that the change of total high-tech medical equipment kinds was significant positive correlated with the change of total number of high-tech medical equipments¡]r = 0.44¡^; the change of total number of high-tech medical equipment was significant positive correlated with average daily emergency roomvisits varience¡]r = 0.28¡^and average daily physical examination of outpatient department visits variance¡]r = 0.30¡^; the average utility of high-tech medical equipment was significant positive correlated with average daily outpatient department visits varience¡]r = 0.27¡^. However, the 3 independent variables have no overall significant effect on change of health service utilization. Based on the above findings, although literature indicated that the kinds and number of high-tech medical equipments somehow might stimulate the demand for health service, we did not find the same results. It could be concluded that hospitals¡¦ purchasing of equipment do not impose a significant impact on raising the medical service utilization. Thus, acquisition of high-tech medical equipment might make a hospital a technological leader or give the public a more professional image whether it can help a hospital raise the service quantity is still left to its management.

No description available.

Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with patient satisfaction, and rurality status did not significantly moderate the relationship. However, the covariates of sexual orientation and income did significantly predict patient satisfaction. This study highlights the complex associations of patient satisfaction, as well as the importance of social determinants of health in patients’ perceptions of quality of care.

Master of Public Health - MPH / Non-communicable diseases (NCDs) are the leading cause of death globally, affecting a significant proportion of the economically active population, the majority of these occurring in low- and middle-income countries (LMICs). In South Africa, over 40% of deaths are attributable to NCDs. The use of healthcare services by individuals who have NCDs is putatively high but has yet, not been adequately quantified. Furthermore, there is a paucity of research data on factors that influence healthcare services use among those experiencing NCDs in South Africa.

Thesis advisor: Shanta Pandey / A growing body of literature, particularly from low and middle-income countries, has focused on the role of male involvement in maternal care as a crucial strategy to improve maternal and neonatal health outcomes. The purpose of this three-paper dissertation is to add to this evidence base within the context of India, and to gain an in-depth understanding of one aspect of male involvement – that is, male partner attendance in antenatal care. This dissertation utilized data from the National Family Health Survey (NFHS-3, 2005-06 and NFHS-4, 2015-16) and was framed using the Social Ecological Model, Connell’s Theory of Gender and Power and a Gender-Transformative lens. Paper 1 summarized the levels of male partner attendance in antenatal care and assessed changes over time. Further, multivariable logistic regression models were used to examine the factors influencing male partner attendance in antenatal care. The results show an overall increase in male partner attendance in India during the period of 2005-06 to 2015-16, with the Southern region reporting the highest level of male partner attendance in both years. Higher level of education and household wealth, increased knowledge of pregnancy-related complications, older age at marriage, and women’s autonomy were positively associated with male partner attendance in antenatal care. Paper 2 examined the association between male partner attendance in antenatal care and maternal health service utilization. Controlling for all socio-demographic variables and adjusting for report of pregnancy complications, the results showed that women who were accompanied by a male partner for antenatal care reported increased odds of maternal health service utilization (early initiation of antenatal care, frequency of antenatal care contacts and institutional delivery). While the place of residence (rural/urban) did not influence the association between male partner attendance and maternal health service utilization, region had a significant moderating effect. Paper 3 examined the association between antenatal care and infant birth weight, adjusting for gestational age. Further, the analysis also assessed whether the relationship between antenatal care and infant birth weight varied by male partner attendance. Findings indicate that early initiation of antenatal care and maternal immunization was associated with reduced odds of low birth weight among infants. The results showed that male partner attendance in antenatal care did not have a moderating influence. Taken together, the findings of the three papers have implications for policy and practice; further, they provide support for interventions that aim for a more inclusive and gender-transformative approach to maternal and neonatal health. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social work.

No description available.

It is widely accepted that the home environment may act as a socio-geographic focus of both disease transmission and of learned health behaviour. Households also appear to be units of convergence for factors identified in the literature as relating to the utilization of health services. This thesis is devoted to an examination of the role of the home environment, as well as of personal characteristics and accessibility, in the utilization of health services in Grenada, West Indies. The theoretical framework that informs this work is a holistic systems-orientated Socio-Ecological Model of Utilization. The empirical analysis draws upon the results of a detailed household survey conducted in five communities on the western portion of the island. Visits to homes containing children less than eight years of age isolated socio-demographic characteristics and information pertaining to residential mobility, household physical and behavioural environment, accessibility, self-reported morbidity and self-reported utilization. Records of patient visits over the previous two years for non-trauma events were abstracted from the medical records of area clinics, hospitals and physicians attending to the sample communities. Bivariate analyses between components of variables were conducted at both household and individual service use levels. These indicated that 1) service utilization was highly clustered around "high user" households and individuals; 2) considerable discrepancies emerged between self-reported and actual utilization; 3) the complexity of relationships between elements of the home environment was highlighted; and 4) there was a consistency with which certain elements of the home environment were statistically associated with health service use across a wide spectrum of illnesses. These observations were further confirmed in multivariate analyses, in which a small number of variables were able to retrospectively predict the presence or absence of service use by both adults and children with a high degree of model specificity and sensitivity. The implications of this work for development and health care planning in Grenada is discussed. The meaningful application of this work in Grenada is seen to hinge upon the extent to which relevant variables are amenable to change or act as proxy variables whose underlying nature of association with utilization remains to be adequately explored. A number of suggestions are advanced concerning the manner in which the study of health service utilization might be approached in the future. / Thesis / Master of Arts (MA)

In this dissertation, I examine individual decisions in occupational choice, labor supply, and health care utilization. Occupational choice decisions of female college graduates on whether to teach or not are analyzed to understand the role of fertility and relative wages using a panel estimation method. I also compare the behavioral changes in the labor force participation among teachers and non-teachers conditional on the presence of a new-born baby. Using the human capital model where a worker decides her hours of work responding to wages, and her human capital is accumulated proportional to her hours of work, I predict that the positive relationship between entry wages and post wages. Empirical evidence suggests that the shock in entry wages may be attributed to post wage differentials. I examine individuals?? choice of health insurance plan and utilization of health care services. Empirical evidence shows that there is favorable self-selection into health maintenance organizations (HMOs) plans and that HMO members use more of office-based and hospital outpatient services. It suggests ineffectiveness of HMO plans in reducing utilization.

In this dissertation, I examine individual decisions in occupational choice, labor supply, and health care utilization. Occupational choice decisions of female college graduates on whether to teach or not are analyzed to understand the role of fertility and relative wages using a panel estimation method. I also compare the behavioral changes in the labor force participation among teachers and non-teachers conditional on the presence of a new-born baby. Using the human capital model where a worker decides her hours of work responding to wages, and her human capital is accumulated proportional to her hours of work, I predict that the positive relationship between entry wages and post wages. Empirical evidence suggests that the shock in entry wages may be attributed to post wage differentials. I examine individuals?? choice of health insurance plan and utilization of health care services. Empirical evidence shows that there is favorable self-selection into health maintenance organizations (HMOs) plans and that HMO members use more of office-based and hospital outpatient services. It suggests ineffectiveness of HMO plans in reducing utilization.

There is extensive research over the decades around health care services utilization trends, however, limited data and research exists around student utilization of campus health centers. Furthermore, there is very minimal data on student utilization trends of campus health services since the onset of the Covid-19 pandemic. Since a crucial component to fostering healthy and safe college campuses is through campus health services, it clearly indicates a need for further research on the trends and perceptions of students’ campus health services utilization. This study examines utilization rates of students through exploring key demographic characteristics of students, including their perceptions toward utilization of campus health services, for their physical well-being and medical care. This dissertation is a secondary data analysis of the American College Health Association-National College Health Assessment. This study’s specific aims were to examine if key characteristics exist of students utilizing campus health centers, and if those trends still exist or had shifted after the Covid-19 pandemic. The data was used to evaluate if there are significant relationships between student demographics and their respective perceptions of campus health services. Drawing on a nationally representative sample of undergraduate students, data analysis found various statistical significance based on the various steps in the Andersen Behavioral Model of Health Services Use. The results confirmed there are barriers to college student utilization of health services, specifically for certain race/ethnicity, international students, having an active health insurance policy, and how they perceive health being a priority on campus. Given the vital role that student health services have on college campuses, efforts to increase campus health service utilization should be considered through targeted programming and more inclusive staffing and service offerings.