Use of Health Services Flashcards
Why is healthcare utilisation important ?
Seeking early diagnosis of some illnesses can make a significant difference :
-treatment success
-degree of procedure used
-survival
e.g. Cancer, Heart Attack
What are some key reasons that people don’t use, overuse, delay using health services ?
Symptom perception
Influence of family/friends
Health beliefs
Social, Emotional factors
Quality of relationship with your GP
What is involved in perceiving symptoms and seeking medical attention ?
- Finding a doctor to contact when unwell
- Deciding when unwell enough to require medical care
Decisions : perceiving and interpreting symptoms
Describe the symptom iceberg
In a 2 week period, 75% of the population will experience >= 1 symptom of ill health.
25% - no symptoms
of the 75% :
- 1/3rd Visit the GP
- 1/3rd Do nothing
- 1/3rd Self-medicate or alternative
Factors affecting symptom perception
Features of symptoms
Individual differences (variations)
Competing environmental stimuli
Psychosocial influences
Socio-cultural differences
Competing environmental stimuli
Extent of attention paid to internal stimuli at any given time, influenced by nature of environmental stimuli present.
What is meant by ‘lay referral’ ?
Lay referral is the process of discussing a symptom or an illness with lay social network members.
It is used to help interpret a symptom
Pennebaker 1983
Assessment of internal states
Miller et al. 1988
Monitors and Blunters
- classifies individuals who monitor and those who don’t
What percentage of patients delay getting treatment for rheumatoid arthritis ?
50%
Normally treatment within 12 week of symptom onset is recommended.
What are some major implications on medical practice, as a result of patients delaying/overusing healthcare ?
Medical education
Health care
Health outcome
What are health beliefs and ideas ?
They are used to develop ideas and expectations about disease.
What is the HBM (Health belief model) useful for ?
Useful for understanding health behaviours (e.g. seeking medical care) based on individuals health beliefs.
What do symptoms initiate ?
A decision making process about seeking medical care.
What is the cognitive model based on ?
Rational information processing, individual thoughts.
Defines behaviour as a result of beliefs that have become refined over time.
Describe the health belief model
Individual perceptions
Modifying factors
Likelihood of action
- Perceived susceptibility
- Perceived severity of the illness
- Cost of carrying out the behaviour
- Benefit of the behaviour
- Cues of action
- Self-efficacy
Evidence for the HBM in relation to the use of health services
Cues to action
- influence people’s practice of preventative measures
e.g. reminders to perform self-examination
Social factors influencing the use of health services
Sex-role stereotypes
Environmental factors (distance from surgery)
Family income
Sanctioning
Emotional factors influencing the use of health services
Embarrassment
Belief in treatment efficacy
Anxiety and fear driven by symptom perception
Who are health service users ?
More females than males
There is a greater use by the elderly
Types of healthcare users
Age
- infants and younger children
- elderly
Gender
- women vs men
- pregnancy and childbirth
Chronic regular user (long term conditions)
Acute irregular user
Treatment delay
The time that elapses between the 1st perception of symptom and when the person enters medical care.
What are the stages in delaying medical care/ treatment ?
3 STAGES
- Appraisal delay
- Illness delay
- Utilisation delay
Appraisal delay
Sensory experience of symptom
‘Am I ill ?’
The time a person takes to interpret a symptom as an indication of illness.
Illness delay
Thoughts about symptom, new ?
‘Do I need professional care ?’
The time between recognising one is ill and deciding to seek medical attention.
Utilisation delay
Benefits and Barriers
‘Is that care worth the costs?’
The time after deciding to seek medical care until actually going in to use that health service.
