Determinants of Medical Care Utilization

Hurtado, Arnold V.; Greenlick, Merwyn R.; Colombo, Theodore J.

doi:10.1097/00005650-197305000-00002

Cited by 76 publications

(15 citation statements)

References 2 publications

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“…In an earlier study of these samne two populations, a comparison of their appointment behavior in the total medical care system showed more variance between the two (24). It appears that members of the poverty population break fewer appointments for mental health clinic services than for other medical services, and that members of the general plan sample break more mental health appointments.…”

Section: Referral Patternsmentioning

confidence: 88%

Use of Mental Health Services by Poverty and Nonpoverty Members of a Prepaid Group Practice Plan

Weiss¹,

Freeborn²,

Lamb³

1973

Health Services Reports

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Section: Referral Patternsmentioning

confidence: 88%

Use of Mental Health Services by Poverty and Nonpoverty Members of a Prepaid Group Practice Plan

Weiss¹,

Freeborn²,

Lamb³

1973

Health Services Reports

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“…Additionally, the attendance rates of scheduled preventative care visits is approximately 50% in adolescent patients 6. The reasons for this are varied but factors correlating with increased missed appointments include minority racial status,7 8 low socioeconomic class,7 – 11 younger age,8 9 10 prior missed appointments,7 larger family size,11 urban social setting,12 marital or family discord13 (as shown in online supplementary table S1) and residential instability 14…”

Section: Introductionmentioning

confidence: 99%

Is it ok 2 txt? Reaching out to adolescents about sexual and reproductive health

Malbon

Romo

2013

Postgraduate Medical Journal

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As the number of adolescents in the population is growing, it is even more important that healthcare practitioners are provided with the tools and resources that can best educate and connect with those patients at risk in this population, particularly with regard to sexual health behaviours. Notoriously, adolescents are difficult to engage in their own healthcare. However, with the advancement of technology and the ubiquitous use of cell phones, emerging studies suggest that there may be benefits to using text messaging within the adolescent health arena to encourage engagement, compliance and improve health knowledge. The use of text messaging has been implemented within adolescent healthcare in multiple ways but studies are needed to evaluate the content of messages, dosage and efficacy of text messaging in improving health outcomes in this population.

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“…Studies of follow-up compliance in adult populations have been reported in the outpatient clinic setting [7][8][9][10][11] ; however, no studies have reported follow-up compliance after an ICU stay. Similarly, no studies of follow-up care after PICU stays have been reported.…”

mentioning

confidence: 99%

Noncompliance With Medical Follow-up After Pediatric Intensive Care

et al. 2002

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ABSTRACT. Objectives. To describe the medical follow-up ordered, the health care utilization, the appointment compliance, and the risk factors associated with noncompliance in patients who are discharged after a pediatric intensive care unit (PICU) stay.Methods. A prospective, analytic, cohort study of 111 critically ill children, age 1 day to 16 years, who were admitted to a 30-bed PICU in an urban, tertiary-care, pediatric teaching hospital compared children who were compliant with medical follow-up with those who were not. The main outcomes measured were emergent and unscheduled physician visits during the first 6 weeks after hospital discharge; compliance with ordered medical follow-up after hospital discharge; and comparisons of socioeconomic, demographic, and medical need factors between compliant and noncompliant children.Discharge orders for follow-up appointments with general pediatricians and subspecialists were collected from the chart at hospital discharge. Patients were contacted after hospital discharge to determine whether and when they received medical follow-up; 28% were found to be noncompliant. Risk factors associated with noncompliance were evaluated. Emergent and unscheduled physician visits were tracked during the first 6 weeks after hospital discharge.Results. Lack of follow-up orders at hospital discharge did not affect the frequency of emergent visits. Children fell into 2 groups: those who were 100% compliant and those with <67% compliance. No socioeconomic or demographic risk factors could be identified between the 2 groups. Compared with the 100% compliant patients, patients who were compliant with <67% of appointments were more severely ill, as defined by higher peak pediatric risk of mortality scores during their PICU stay (11.5 vs 8.4), longer PICU length of stays (10.1 days vs 4.6 days), and longer hospital length of stays (25.5 days vs 14 days). Most predictive of noncompliance was the number of medical appointments ordered by physicians. Patients with 3 or more appointments were less likely to be compliant with follow-up. After hospital discharge, children were more likely to visit a primary care physician compared with a subspecialist (95% vs 82%). When patients were ordered to see a specialist, scheduled appointments were much better attended than the recommended appointments (92% vs 67%).Conclusions. Lack of ordered medical follow-up did not affect emergent visits. In this group of critically ill children, a significant percentage (28%) did not receive timely medical follow-up. No socioeconomic or demographic risk factors were identified in noncompliant children. However, severity of illness (higher peak pediatric risk of mortality score, longer PICU stay, and longer hospital stay) and the number of follow-up appointments ordered were predictors of noncompliance. Potential exists for implementing strategies to improve compliance in identified populations. Pediatrics 2002;109(6). URL: http://www.pediatrics.org/cgi/content/full/109/6/ e94; compliance, follow-up, predictors, ped...

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Determinants of Medical Care Utilization

Abstract: A multidimensional approach to the study of the factors that determine medical care utilization is

Cited by 76 publications

References 2 publications

Use of Mental Health Services by Poverty and Nonpoverty Members of a Prepaid Group Practice Plan

Use of Mental Health Services by Poverty and Nonpoverty Members of a Prepaid Group Practice Plan

Is it ok 2 txt? Reaching out to adolescents about sexual and reproductive health

Noncompliance With Medical Follow-up After Pediatric Intensive Care

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