Importance of healthcare utilization and multimorbidity level in choosing a primary care provider in Sweden

Ranstad, Karin; Midlöv, Patrik; Halling, Anders

doi:10.3109/02813432.2014.929819

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…But usefulness of such a valid model is manifold, i.e. in understanding the pro CAM decision, predicting such choice and decision, formulating healthcare strategies and development of health human resource accordingly [19,20]. The study by Fouladbakhsh and Stommel [21] took socio-behavioural model (SBM) guided by Andersen as baseline of determining the choice dynamics of CAM in cancer and non-cancerous patients.…”

Section: Discussionmentioning

confidence: 99%

Factors determining choice of complementary and alternative medicine in acute and chronic diseases

Chowdhuri

Kundu

2020

Journal of Complementary and Integrative Medicine

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BackgroundSystematic analysis of the determinants of choice of a treatment modality aids to the understanding of decision process of healthcare utilization. The revealed preference of a single modality may differ according to the nature of disease. Existing studies have not integrated possible causal factors in a model with respect to diseases. This study identifies major determinants and formulates their integral effect on choice of a particular modality on acute and chronic diseases in accordance to socio-behavioural model.MethodologyA cross-sectional study on 300 samples using a 30-point questionnaire, developed in Likert scale and dichotomous scale. Possible determinants are tested on choice of CAM in case of acute disease and of chronic disease separately.ResultsRevealed single modality treatment preference (of CAM) varies widely between acute disease (13%) and chronic disease (58.67%). Bivariate associations are significant for gender (For, overall CAM preference, p=0.001, acute disease, p<0.001, chronic disease, p=0.024), Disease burden (overall and chronic: p<0.001, acute: p=0.008) and previous CAM usage (overall and chronic: p<0.001, acute: p=0.016). Social factor individually has significant influence on choosing CAM both acute (OR=1.096, p<0.001) and chronic disease (OR=1.036, p<0.001). Ideation of philosophical need factor, guided by philosophical congruence with CAM (OR=1.047, p<0.001) is a novel finding of this study. While with multiple logistic regression male gender (p=0.03), social factor (p<0.001), perception of CAM efficacy (p=0.02) and negative ideation about CAM cost-effectiveness (p=0.002) are found to be important in Acute disease; choosing CAM in chronic disease is guided by female gender (p=0.001), making decision in-group (p=0.001), low disease burden (p<0.001), philosophical need factor (p=0.001), and perception of CAM efficacy (p<0.001).ConclusionDemographic, social, cognitive and philosophical factors are important determinants of choosing CAM as a treatment modality over conventional medicine, but they act differently on CAM preference in acute and chronic diseases.

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Section: Discussionmentioning

confidence: 99%

Factors determining choice of complementary and alternative medicine in acute and chronic diseases

Chowdhuri

Kundu

2020

Journal of Complementary and Integrative Medicine

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“…Elderly women are more often hospitalised, have longer stays at hospitals and have higher rates of most chronic diseases than men [ 22 ]. Other studies from Blekinge County showed that multimorbidity level is positively correlated with number of consultations in PHC [ 23 ], and that women and individuals with higher multimorbidity level were more often actively listed at PHC [ 23 , 24 ]. In our study we found that even home health care utilisation is associated with multimorbidity level and gender, especially in older women.…”

Section: Discussionmentioning

confidence: 99%

Association between age, gender and multimorbidity level and receiving home health care: a population-based Swedish study

Zieliński¹,

Halling

2015

BMC Res Notes

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BackgroundHome health care is an important part of primary health care. How delivery of home health care is organised is probably important for sustainability of the healthcare system as a whole. More than 50 % of individuals over 65 years old have multimorbidity, which increases with higher age, also influencing the needs of home health care. Our aim was to study the proportion of the population above 65 years receiving home health care according to age, gender and multimorbidity level.MethodsThe study population comprised 32,130 people aged 65 or more, living in Blekinge County in southern Sweden. We analysed data from patient electronic medical records for patients receiving home health care delivered in patients’ own homes by nurses, physiotherapists and occupational therapists. We used the Adjusted Clinical Groups Case-Mix System in order to group individuals according to diagnoses into six levels of multimorbidity. In order to analyse the differences between individuals receiving home health care and those who did not, we used Chi squared test. Logistic regression analysis was conducted in order to study how the dependent variable was influenced by the independent variables.ResultsA total of 7860 (28 %) of the studied population received home health care in 2011. Logistic regression analysis showed that men had 26 % lower odds of receiving home care compared to women (OR = 0.74, 95 % CI 0.69–0.78). There was also a substantial group (22 %) with low multimorbidity level among people receiving home health care. Adjusting for gender and age showed no differences in odds of receiving home health care for patients with lower levels of multimorbidity. However, for patients with higher levels of morbidity the odds increased dramatically for both genders.ConclusionThe question of to whom and to what extent home health care should be provided is an important challenge for policy makers. Our results show that there are differences in the use of home health care dependent on gender, age and multimorbidity level, but also that home health care is provided to individuals with low morbidity. Further studies could explain the factors influencing home health care use.

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“… 25 In a previous paper, we found that more consultations, higher multimorbidity level, older age and female gender were positively associated with active listing in primary care. 26 Here we combined these factors with socioeconomic status, type of primary care practice and geographical factors, and we found that multimorbidity level, age and geographical location contributed most to active listing and that type of primary care practice contributes more than socioeconomic status and distances to healthcare.…”

Section: Discussionmentioning

confidence: 97%

Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care

2017

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BackgroundSocioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient’s choice of practice, this choice (listing) is a key to understand the system.ObjectiveTo explore the relationship between population and practices in a primary care system based on listing.MethodsCross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice.Setting and subjectsPopulation over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%.Main outcome measureActively listed in primary care on 31 December 2007.ResultsHighest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike’s Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934.ConclusionsHigher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care.Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare.

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Importance of healthcare utilization and multimorbidity level in choosing a primary care provider in Sweden

Cited by 14 publications

References 20 publications

Factors determining choice of complementary and alternative medicine in acute and chronic diseases

Factors determining choice of complementary and alternative medicine in acute and chronic diseases

Association between age, gender and multimorbidity level and receiving home health care: a population-based Swedish study

Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care

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