A study of hospital utilization by the cost of care to patients in a private university hospital in Seoul, Republic of Korea, 1955--1974

Health services utilization patterns of two urban communities in Abha, Saudi Arabia

A 20% random sample of 146 families including 942 individuals was selected from two urban communities in Abha City in Saudi Arabia in order to assess the pattern of health services utilization. The information was obtained from the heads of families through interviews using a structured questionnaire. Health "wants" of the people to improve health services were also determined. Of all the health problems encountered in the sample, 84% received health services from the Primary Health Care Center (PHCC) and from the hospital out-patient department. Seventy percent of the deliveries were conducted at the hospital, and the average hospital stay for a delivery was 2.9 days. The overall annual hospitalization rate for the population under study was 89 per 1,000 population, with an average hospitalization period of 7.5 days per case. Deliveries constituted the leading cause for hospitalization. Only 52% of the deliveries received postnatal care, mostly in the hospital, whereas 88 per cent of the pregnancies received antenatal care, mainly in the PHCC. The outreach services of the PHCC were very deficient and lacked the basic elements of preventive services. The role of the hospital and PHCC should be adjusted to meet the health needs of the people, and the people's health "wants" which reflect their sociocultural background should be given attention in health planning.

Health services utilization and cost in Ismailia, Egypt

A pilot study has been undertaken to assess the utilization patterns of health services and to estimate the expenditure on health care in the Governorate of Ismailia, Egypt. A stratified random sample of 89 households (576 individuals), along with 5 pharmacies, 4 primary health care units (PHCUs) and 10 traditional health workers (THWs) has been selected and studied using personal interviews. PHCUs are facilities affiliated with the Governorate Health Directorate and provide free public primary health care services. They include rural health units, rural hospitals and urban health centres. THWs are individuals with informal training and experience in medical care, and officially unrecognized, but provide some primary health care services to the people. They include traditional midwives (TMs) and traditional healers (THs). The estimated average annual per capita expenditure on health care was L.E. 9.2 (Egyptian L.E. approximately or equal to US$ 1.25). The per capita cost of medication (L.E. 3.5) was double the cost of physicians' fees (L.E. 1.77). An annual rate of hospital admission of 24.3 per 1000 population at an average cost of L.E. 10.5 per case admitted was incurred by the sample. There is evidence that the PHCUs have not been utilized efficiently and there was some degree of dissatisfaction with their services. The households relied more on private physicians as their first contact for seeking help for health problems. The majority utilized TMs for care of delivery despite the shortcomings in their training and supervision. Eighty per cent of the mothers in the sample have had no ante-natal care during pregnancy despite the availability of such care in the PHCUs. Possible reasons for these underutilization patterns of the PHCUs have been discussed, and major approaches for increasing the efficiency and utilization of the health services have been proposed. THWs should be officially recognized by health authorities, should be properly trained and supervised, and their services should be fully integrated with the community health care programmes. Also, programmes for proper administration, organization and supervision of the PHCUs and programmes. Also, programmes for proper administration, organization and supervision of the PHCUs and programmes for developing health manpower responsive to community health needs should be planned and implemented. Finally, a flexible system to compensate fairly physicians and staff of the PHCUs and to allow reasonable chance for physicians for private practice must be established.(ABSTRACT TRUNCATED AT 400 WORDS)