Use of Health Services

Question 1

Why is healthcare utilisation important ?

Answer 1

Seeking early diagnosis of some illnesses can make a significant difference :

-treatment success
-degree of procedure used
-survival

e.g. Cancer, Heart Attack

Question 2

What are some key reasons that people don’t use, overuse, delay using health services ?

Answer 2

Symptom perception
Influence of family/friends
Health beliefs
Social, Emotional factors
Quality of relationship with your GP

Question 3

What is involved in perceiving symptoms and seeking medical attention ?

Answer 3

1. Finding a doctor to contact when unwell
2. Deciding when unwell enough to require medical care

Decisions : perceiving and interpreting symptoms

Question 4

Describe the symptom iceberg

Answer 4

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

Question 5

Factors affecting symptom perception

Answer 5

Features of symptoms
Individual differences (variations)
Competing environmental stimuli
Psychosocial influences
Socio-cultural differences

Question 6

Competing environmental stimuli

Answer 6

Extent of attention paid to internal stimuli at any given time, influenced by nature of environmental stimuli present.

Question 7

What is meant by ‘lay referral’ ?

Answer 7

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

Question 8

Pennebaker 1983

Answer 8

Assessment of internal states

Question 9

Miller et al. 1988

Answer 9

Monitors and Blunters

• classifies individuals who monitor and those who don’t

Question 10

What percentage of patients delay getting treatment for rheumatoid arthritis ?

Answer 10

50%

Normally treatment within 12 week of symptom onset is recommended.

Question 11

What are some major implications on medical practice, as a result of patients delaying/overusing healthcare ?

Answer 11

Medical education
Health care
Health outcome

Question 12

What are health beliefs and ideas ?

Answer 12

They are used to develop ideas and expectations about disease.

Question 13

What is the HBM (Health belief model) useful for ?

Answer 13

Useful for understanding health behaviours (e.g. seeking medical care) based on individuals health beliefs.

Question 14

What do symptoms initiate ?

Answer 14

A decision making process about seeking medical care.

Question 15

What is the cognitive model based on ?

Answer 15

Rational information processing, individual thoughts.

Defines behaviour as a result of beliefs that have become refined over time.

Question 16

Describe the health belief model

Answer 16

Individual perceptions
Modifying factors
Likelihood of action

1. Perceived susceptibility
2. Perceived severity of the illness
3. Cost of carrying out the behaviour
4. Benefit of the behaviour
5. Cues of action
6. Self-efficacy

Question 17

Evidence for the HBM in relation to the use of health services

Answer 17

Cues to action
- influence people’s practice of preventative measures
e.g. reminders to perform self-examination

Question 18

Social factors influencing the use of health services

Answer 18

Sex-role stereotypes
Environmental factors (distance from surgery)
Family income
Sanctioning

Question 19

Emotional factors influencing the use of health services

Answer 19

Embarrassment
Belief in treatment efficacy
Anxiety and fear driven by symptom perception

Question 20

Who are health service users ?

Answer 20

More females than males
There is a greater use by the elderly

Question 21

Types of healthcare users

Answer 21

Age
- infants and younger children
- elderly

Gender
- women vs men
- pregnancy and childbirth

Chronic regular user (long term conditions)

Acute irregular user

Question 22

Treatment delay

Answer 22

The time that elapses between the 1st perception of symptom and when the person enters medical care.

Question 23

What are the stages in delaying medical care/ treatment ?

Answer 23

3 STAGES

1. Appraisal delay
2. Illness delay
3. Utilisation delay

Question 24

Appraisal delay

Answer 24

Sensory experience of symptom
‘Am I ill ?’

The time a person takes to interpret a symptom as an indication of illness.

Question 25

Illness delay

Answer 25

Thoughts about symptom, new ?
‘Do I need professional care ?’

The time between recognising one is ill and deciding to seek medical attention.

Question 26

Utilisation delay

Answer 26

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.