Volume 6, Issue 4 (Autumn 2018)
Iran J Health Sci 2018, 6(4): 30-39 |
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Rouhani S, Daryabary S H. Curative Care Utilization under Family Medicine and Rural Insurance in Amol – Iran. Iran J Health Sci 2018; 6 (4) :30-39
URL: http://jhs.mazums.ac.ir/article-1-592-en.html
URL: http://jhs.mazums.ac.ir/article-1-592-en.html
Mazandaran University of Medical Sciences, Sari, Iran , hddh111367@gmail.com
Abstract: (2996 Views)
Background and purpose: Reliable information about utilization of medical services is key for making appropriate decisions of all healthcare systems. Nonetheless, most policy decisions and planning in the rural areas of developing countries are made with the lack of such crucial information. In this article we attempt to reveal the pattern of curative care utilization of rural population in Amol, a county in Northern Province of Mazandaran.
Methods: In this study 355 patients living in rural area who in the last three month utilized curative care from different providers were interviewed in their doorsteps. All interviewees were heads of family or people age above 15. SPSS software was used for analyzing the data.
Results: About a quarter of patients (24.5%) have referred to their local family physicians. It is noticeable that the proportion of people who referred to GP out of family physicians scheme exceeds the proportion of patients referred to GPs who are working as family physicians in the FMRI scheme. Among the studied variables, only basic insurance, severity of disease, and type of care utilized had significant association with referred or not referred of individuals to their own family physicians.
Conclusion:Family medicine and rural insurance in Iran has increased the overall service utilization of population in rural areas but not in the scale that the government has spent its limited healthcare resources. This raises the concern of inappropriate resource allocation for inappropriate people and inappropriate services.
Keywords:
Methods: In this study 355 patients living in rural area who in the last three month utilized curative care from different providers were interviewed in their doorsteps. All interviewees were heads of family or people age above 15. SPSS software was used for analyzing the data.
Results: About a quarter of patients (24.5%) have referred to their local family physicians. It is noticeable that the proportion of people who referred to GP out of family physicians scheme exceeds the proportion of patients referred to GPs who are working as family physicians in the FMRI scheme. Among the studied variables, only basic insurance, severity of disease, and type of care utilized had significant association with referred or not referred of individuals to their own family physicians.
Conclusion:Family medicine and rural insurance in Iran has increased the overall service utilization of population in rural areas but not in the scale that the government has spent its limited healthcare resources. This raises the concern of inappropriate resource allocation for inappropriate people and inappropriate services.
Keywords:
Type of Study: Original Article |
Subject:
Health
References
1. Baker JB, Liu L. The determinants of primary health care utilization: a comparison of three rural clinics in Southern Honduras. Geo Journal. 2006;66(4):295-310. [DOI:10.1007/s10708-006-9001-8]
2. Luo W, Qi Y. An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians. Health & Place. 2009;15(4):1100-7. [DOI:10.1016/j.healthplace.2009.06.002] [PMID]
3. Alkhawaldeh A, Holm MB, Qaddumi J, Petro W, Jaghbir M, Al Omari O. A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan. Current Gerontology and Geriatrics Research. 2014;1-7. [DOI:10.1155/2014/735235] [PMID] [PMCID]
4. Keya KT, Rob U, Rahman MM, Bajracharya A, Bellows B. Distance, transportation cost, and mode of transport in the utilization of facility-based maternity services: evidence from rural Bangladesh. International quarterly of community health education.35 (1):37-51. [DOI:10.2190/IQ.35.1.d] [PMID]
5. Feikin DR, Nguyen LM, Adazu K, Ombok M, Audi A, Slutsker L, et al. The impact of distance of residence from a peripheral health facility on pediatric health utilization in rural western Kenya. Tropical medicine & international health. 2009;14(1):54-61. [DOI:10.1111/j.1365-3156.2008.02193.x] [PMID]
6. Catherine A. Pearson, Michael P. Stevens, Kakotan Sanogo, and Gonzalo M. L. Bearman, "Access and Barriers to Healthcare Vary among Three Neighboring Communities in Northern Honduras," International Journal of Family Medicine, vol. 2012, Article ID 298472, 6 pages, 2012.
7. Andersen RM, Davidson PL, Baumeister SE. Improving access to care. Changing the US health care system: key issues in health services policy and management, 4th Edition, San Francisco: Jossey-Bass.2013.
8. Andersen RM. National health surveys and the behavioral model of health services use. Medical care. 2008; 46(7):647-53. 9. World Health Organization. The world health report 2000: health systems: improving performance. Geneva, World Health Organization; 2000.
9. Sayari AA, Kalantari N, Rafieifar S., et al. A report on reform and achievement in health sector in 11th Cabinet of Islamic Republic of Iran. Ministry of Health & Medical Education, Deputy for Health; Tehran. 2016.
10. Rouhani S, Abdollahi F, Mohammadpour RA. The Association between Family Socio-Economic Status and Health Care Utilization in Ghaemshahr-Mazandaran, Iran. Iranian journal of health sciences.2014;2(4):52-8. [DOI:10.18869/acadpub.jhs.2.4.52]
11. Alavian SM. Determinants of seeking needed outpatient care in Iran: results from a national health services utilization survey. Archives of Iranian medicine. 2007;10(4):439-45. [PMID]
12. Motlagh SN, Sabermahani A, Hadian M, Lari MA, Mahdavi MRV, Gorji HA. Factors Affecting Health Care Utilization in Tehran. Global Journal of Health Science. 2015;7(6):240-249. [PMCID]
13. Newhouse JP, Manning WG, Morris CN, Orr LL, Duan N, Keeler EB, et al. Some interim results from a controlled trial of cost sharing in health insurance. New England Journal of Medicine. 1981;305(25):1501-7. [DOI:10.1056/NEJM198112173052504] [PMID]
14. Mendoza-Sassi R, Béria JU, Barros AJD. Outpatient health service utilization and associated factors: a population-based study. Revista de Sa ̇ude P ̇ublica. 2003;37(3):372-8. [DOI:10.1590/S0034-89102003000300017]
15. Vilhjalmsson R. Failure to seek needed medical care: Results from a national health survey of Icelanders. Social science & medicine. 2005;61(6):1320-30. [DOI:10.1016/j.socscimed.2005.01.024] [PMID]
16. Moosazadeh M, Abedi G, Farshidi F, Naghibi A, Rostami F, Afsharimoghaddam A. Satisfaction rate of service recipients and providers of rural family physician program in Iran: A systematic review and meta-analysis. Journal of Mazandaran University of Medical Sciences.2015; 25(131):165-80.
17. Rouhani S, Mohammadpour RA. Family medicine and patients' satisfaction in Iran. Life Science Journal. 2012; 9(3):1840-7.
18. Rouhani S, Alipoor Landy S. The Economic Standpoint of Referral System at Using Tertiary Hospital Services in Iran. Iranian journal of health sciences. 2017; 5(1):38-48. [DOI:10.18869/acadpub.jhs.5.1.38]
19. Nasrollahpour Shirvani SD, Raeisee P, Motlagh ME, Kabir MJ, Ashrafian Amiri H. Evaluation of the Performance of Referral System in Family Physician Program in Iran University of Medical Sciences. 2009, Hakim Research Journal.2010; 13(1):19-25.
20. Rouhani S, Bagher M. Experience of Family Physicians in Rural Areas Regarding Referral System and Improving it (A qualitative study). Journal of Mazandaran University of Medical Sciences.2015; 25(131):1-13.
21. SafizadeheChamokhtari K, Abedi G, Marvi A. Analysis of the Patient Referral System in Urban Family Physician Program, from Stakeholders Perspective Using SWOT Approach: A Qualitative Study. Journal of Mazandaran University of Medical Sciences.2018; 28(161):75-87.
22. Shirvani N, Davoud S, Mikanik E, Ashrafian Amiri H, Kabir MJ, Jafari N, et al. Evaluation of the referral system situation in family physician program in northern provinces of Iran: 2012-2013. Journal of Mazandaran University of Medical Sciences. 2014; 23(109):27-35.
23. Rouhani S, Yazdani Charati J, Mohammadpour RA. Structural Quality and Utilization of Outpatient Curative Care Under Family Medicine Scheme in Rural Area of Mazandaran. Iran. Iranian journal of health sciences. 2013; 1(2):28-34.
24. Rouhani S, Akbarzadeh F. The impact of change of payment mechanism on the performance of rural health centers in ambulatory care under family medicine scheme in Sari and Joybar. Journal of Mazandaran University of Medical Sciences. 2013; 22(1):96-103.
25. Organization Map. Law of the Forth Economic, Social and Cultural Development Plan of the Islamic Republic of Iran, 2005 – 2009. Tehran: Management and planning Organization; 2005.
26. Witter S, Ensor T, Jowett M, Thompson R. Health Economics for Developing Countries: A Practical Guide. First edition, MacMillan Education, London, 2000. [PMCID]
27. Zyaambo C, Siziya S, Fylkesnes K. Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia. BMC health services research, 2012;12(1):389. [DOI:10.1186/1472-6963-12-389] [PMID] [PMCID]
28. Hansen AH, Halvorsen PA, Ringberg U, Fأ¸rde OH. Socio-economic inequalities in health care utilization in Norway: a population based cross-sectional survey. BMC health services research. 2012,12(1):336-348. [DOI:10.1186/1472-6963-12-336] [PMID] [PMCID]
29. Nguyen LT, Davis RB, Kaptchuk TJ, Phillips RS. Use of complementary and alternative medicine and self-rated health status: results from a national survey. Journal of general internal medicine.2011;26(4):399-404. [DOI:10.1007/s11606-010-1542-3] [PMID] [PMCID]
30. Siziya S, Fylkesnes K. Impact of HIV infection on self-rated health in a high-prevalence population with low awareness of own HIV status. Norsk Epidemiologi. 2009;15(2):165-173. [DOI:10.5324/nje.v15i2.215]
31. Mirowsky J. Education, social status, and health. First edition, Taylor & Francis, 2017. [DOI:10.4324/9781351328081] [PMCID]
32. Oladigbolu RA, Oche MO, Kaoje AU, Gana GJ. Socio-economic Factors Influencing Utilization of Healthcare Services in Sokoto, North-Western Nigeria. International Journal of TROPICAL DISEASE & Health, 2017; 27(2):1-13. [DOI:10.9734/IJTDH/2017/35282]
33. Prosser T. Utilization of health and medical services: factors influencing health care seeking behavior and unmet health needs in rural areas of Kenya. Ph.D Thesis, Edith Cowan University, 2007.
34. Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K. Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malaria journal. 2009;8(1):45. [DOI:10.1186/1475-2875-8-45] [PMID] [PMCID]
35. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. The Lancet. 2013;382(9908):1898-955. [DOI:10.1016/S0140-6736(13)62105-4]
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