UNLABELLEDOBJECTIVE To understand the demands and influencing factors on the community-based health care service (CHS) among the elderly and to provide evidence of implementing health service for them

METHODSCluster sampling method was used on 717 persons aged 60 and above in Yanjiao Developing Area. A survey was carried out, using questionnaire and focus group discussion approaches.

RESULTSData showed that a two-week prevalence of diseases was 56.3% while the overall prevalence of chronic diseases was 92.1% with 70.0% of them suffering from more than two kinds of chronic diseases. The rates of ADL and IADL loss were 1.8% and 7.0% respectively with 37.0% of them sought medical consultation in the past two weeks. Major reason affecting the use of health service was low income. 57.7% of the elderly expressed their willingness of accepting CHS with the strongest demands as regular physical check-up, health education and consultation, specialized care services, home care service while major reasons hindering the acceptance of CHS could be referred to self-perception on good stamina and lack of awareness to CHS.

CONCLUSIONThe demands of CHS in the elderly were greater than those in general population that called for CHS programs to be acceptable and relevant to meet the different needs.

Aged ; China ; Community Health Services ; statistics & numerical data ; Female ; Health Services Needs and Demand ; statistics & numerical data ; Health Surveys ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care ; statistics & numerical data

OBJECTIVETo provide insight on psychosocial factors underlying utilization of health services of women whom perceived reproductive tract infection (RTI) symptoms.

METHODSA cross-sectional study, adopted Aday and Andersen's Social Behaviour Model was conducted in 1998 - 1999 in China. Hebei province and Beijing were purposely chosen as the research sites. All eligible married women aged 21 to 60, 864 subjects, were interviewed in person.

RESULTSFindings showed that the percentage of self-reported symptoms of RTIs was 35.6 in urban compared to 46.8 in the rural areas. The proportion of women with RTIs who utilized health services was 27.5 versus 26.7 percent among the two groups. Urban women, mostly 'white collar' class, with free medical service, satisfied with health providers, receiving information from health provider and having severe current experience RTIs, were more likely to use health services. Rural women, however, having both severe prior experience and current experience of RTIs, high family income, having much knowledge about self-medication, perceiving less social stigma of getting RTIs, and perceiving severity of RTIs, were more likely to use health services.

CONCLUSIONThese findings showed that there was a great need on providing culturally acceptable reproductive health education at different places so as to improve women's ability of self-care. Regular medical check-up for women is also important for improving the quality of health service. Reform on health insurance seemed necessary. Factors as social stigma related to RTIs, giving women social and moral support also need to be taken into account.

Adult ; China ; Cross-Sectional Studies ; Female ; Health Services ; utilization ; Health Services Research ; statistics & numerical data ; Humans ; Infection ; therapy ; Male ; Middle Aged ; Rural Health ; statistics & numerical data ; Urban Health ; statistics & numerical data

OBJECTIVETo analyze the dental care utilization and expenditure of residents in Beijing, and to provide some basis on the policy of oral health insurance system.

METHODSA cross-sectional survey was conducted among 1,517 subjects (urban area) and 1,878 subjects (rural area) of all age groups in Beijing selected by stratified, clustering, random sampling. The data of oral health care utilization and expenditure were collected in their home.

RESULTSThe number of the people who visited a dentist in a year were low both in urban area and in rural area, but the expenditure for oral health care per visit were quite high. The value of utilization of dental care in rural residents was 1/3 of that in urban residents, while the value of expenditure in rural people was about 1/2 of that in urban people. 2.07% incomes of rural residents were used for dental care per year, the corresponding value of urban residents was 1.77%. There was significant difference on the expenditure among those with different demographic, socio-economic backgrounds.

CONCLUSIONSThe expenditure for oral health care was high in Beijing, which accounted for quite a lot in average incomes per year. The burden of expenditure for dental care on rural residents was heavier than that on urban residents. The level of expenditure for dental care could provide some references for oral health insurance system in Beijing.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Dental Health Services ; economics ; statistics & numerical data ; Fees, Dental ; Female ; Health Services Accessibility ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Insurance, Dental ; Male ; Middle Aged ; Rural Health Services ; statistics & numerical data ; Urban Health Services ; statistics & numerical data

OBJECTIVES: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. METHODS: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. RESULTS: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. CONCLUSIONS: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.
Aged ; *Blood Pressure ; Chronic Disease ; Female ; Health Services Accessibility/*statistics & numerical data ; Health Status ; Humans ; Korea/epidemiology ; Male ; Neoplasms/*diagnosis ; Physical Examination/*statistics & numerical data ; Preventive Health Services/*statistics & numerical data ; Residence Characteristics ; Sex Factors ; Socioeconomic Factors

OBJECTIVE: To investigate the treatment compliance and basic health needs of rural patients with gastric ulcer. METHODS: One hundred and sixteen patients with gastric ulcer were measured with treatment compliance questionnaire. The questionnaire contained 3 aspects: chemical therapy, regular callback, and improvement in life style, and had another part of questions which were designed to investigate the basic health needs of the patients. RESULTS: The patient compliance rate in the aspect of improvement in life style was 4.3% (n=5). Both of the counterparts in the other 2 aspects were 7.8% (n=9). The main correlative factor with treatment compliance of the investigated patients was economic income. There were 105 patients (90.5%) needing health consultation, 98 patients (84.5%) needing diet instruction and 93 patients (80.2%) needing regular physical examination among the 116 patients investigated. CONCLUSION The treatment compliance rate of rural patients with gastric ulcer was very low. It is necessary to emphasize health education.
Adolescent ; Adult ; Aged ; Female ; Health Services Needs and Demand ; Humans ; Male ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Peptic Ulcer ; Rural Health Services ; Surveys and Questionnaires ; Young Adult

OBJECTIVES: The purpose of this study was to examine the relationship between the differences in employment status and self assessed health in Korea. METHODS: We analyzed 4 year follow-up data generated by the Korean Labor and Income Panel Study(KLIPS), which was conducted on 1,207 men and 582 women who had undergone a change in employment status. The study subjects were placed into 1 of the following 4 groups based on their employment history; Non-precarious workers, Precarious to non-precarious workers, Non-precarious to precarious workers and Precarious workers. Logistic regression was then used to examine the relationship between the changes in employment status and self assessed health. RESULTS: When males were considered, self assessed health was better among the precarious to non-precarious workers (OR 1.58, 95% CI=1.57-1.60) and the precarious workers (OR 1.29, 95% CI=1.28-1.30) than in the non-precarious workers, after adjusting for age, socioeconomic status (education level, occupational class, marital status, average equivalent household income and average number of hours worked per week), health behavior (smoking, drinking and exercise) and medical service access (regular medical examination, have chronic disease or hospitalized within 1 year). When female workers were considered, the precarious to non-precarious workers (OR 1.89, 95% CI=1.86-1.92), non-precarious to precarious workers(OR 1.24, 95% CI=1.23-1.26) and precarious workers (OR 1.27, 95% CI=1.25-1.28) all reported poorer health than the non-precarious workers after adjusting for the aforementioned factors. CONCLUSIONS: This study showed that changes in employment status were associated with differences in self assessed health among men and women. Specifically, the results of this study showed that a corresponding positive outcome based on self assessed health was greater for employees that changed from precarious to non-precarious jobs and for male employees with precarious jobs, whereas female employees with non-precarious jobs had higher self assessed health. However, additional longitudinal studies on the health effects of employment status should be conducted.
Adult ; Employment/*statistics & numerical data ; Female ; Health Behavior ; Health Services Accessibility/*statistics & numerical data ; Health Status ; Humans ; Korea ; Male ; Middle Aged ; Sex Factors ; Socioeconomic Factors

Adolescent ; Adult ; Female ; Health Education ; Health Knowledge, Attitudes, Practice ; Health Services Needs and Demand ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Rural Population ; statistics & numerical data ; Surveys and Questionnaires ; Transients and Migrants ; statistics & numerical data ; Young Adult

Against the backdrop of population aging, this paper presents the analysis of need-standardised health care utilization among elderly in India. Based on nationally representative morbidity and health care survey 2004, we demonstrate that the need for health care utilization is indeed pro-poor in nature. However, the actual health care utilization is concentrated among richer sections of the population. Further, the decomposition analysis reveals that income has a very strong role in shifting the distribution of health care away from the poor elderly. The impact of income on utilization is well-demonstrated even at the ecological-level as states with higher per capita incomes have higher elderly health care utilization even as the levels of need-predicted distribution across these states are similar. We also find that the distribution of elderly across social groups and their educational achievements favours the rich and significantly contributes to overall inequality. Nevertheless, contribution of need-related self-assessed health clearly favours pro-poor inequality. In concluding, we argue that to reduce such inequities in health care utilization it is necessary to increase public investments in health care infrastructure including geriatric care particularly in rural areas and underdeveloped regions to enhance access and quality of health care for the elderly.
Aged ; Aged, 80 and over ; *Cultural Characteristics ; Evidence-Based Medicine ; Female ; Health Care Rationing/*statistics & numerical data ; Health Equity/*statistics & numerical data ; Health Services for the Aged/*utilization ; Humans ; Income/*statistics & numerical data ; India/epidemiology ; Male ; Middle Aged ; Socioeconomic Factors ; *Utilization Review

OBJECTIVETo investigate the utilization of oral health services and to analyze the factors associated with oral health services for the community residents.

METHODSHousehold health interview and oral health condition survey were conducted to obtain information about oral health services. The respondents were recruited by a multi-stage random cluster sampling procedure. Multiple dummy regression analyses were performed for the assessment of the relative effect of behavioural factors on dental attendance.

RESULTSA total of 2003 families, 4459 people participated in this study. The people seeking dental treatment accounted for 11.3% (502/4459) per year. Young people (OR = 2.072), having medical insurance system (OR = 2.835), short distance to see dentist (OR = 3.535), oral health awareness (OR = 2.595), poor self-assessment of oral health status (OR = 2.014) were the main factors which influenced dental attendance of community residents.

CONCLUSIONSThe utilization of oral health service was low, particularly for middle-aged people and the elderly. Oral health education and medical insurance system should be strengthened.

Adolescent ; Adult ; Aged ; Dental Care ; economics ; utilization ; Dental Health Services ; economics ; utilization ; Health Services Accessibility ; statistics & numerical data ; Health Services Needs and Demand ; Humans ; Income ; statistics & numerical data ; Insurance, Dental ; statistics & numerical data ; Logistic Models ; Middle Aged ; Sampling Studies ; Self-Assessment ; Surveys and Questionnaires ; Urban Health Services ; utilization ; Urban Population ; Young Adult

OBJECTIVETo explore the factors which influencing the intelligence in elderly in a community, so as to provide reference on primary prevention of dementia.

METHODSA door to door survey was conducted. A total number of 830 elderly were assessed using WAIS-RC, H-NTLA and data collected through questionnaires on lifestyles, family and social activity were analysed, using the factor analysis, stepwise regression and canonical correlation analysis.

RESULTSThe main variables related to the verbal were eggs diet, blood pressure, fruit, visit their children, alcohol intake (standard coefficients of regression are -0.118, -0.079, -0.060, -0.036, -0.117, respectively). The main variables related to cognition were recreation, sports and hereditary history of mental disorders (standard coefficients of regression were 0.035, -0.127, respectively). The main variables related to memory were contact to chemical materials, age of their parents during delivery, alcohol intake and the relationship between husband and wife (standard coefficients of regression were -0.063, 0.055, -0.030, -0.037, respectively). The variables related to canonical variable V(1) would include education and occupation (canonical correlation = 0.5993, P = 0.0001) while V(2) would include cerebrovascular accident (canonical correlation = 0.3925, P = 0.0005).

CONCLUSIONIntelligent work, family harmony, prevention of cerebrovascular diseases were the main areas to prevent intellectual disability in the elderly.

Aged ; China ; Community Health Services ; statistics & numerical data ; Dementia ; prevention & control ; Factor Analysis, Statistical ; Female ; Health Services for the Aged ; statistics & numerical data ; Humans ; Intelligence ; physiology ; Life Style ; Male ; Middle Aged ; Quality of Life ; Regression Analysis ; Surveys and Questionnaires