Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review.
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ABSTRACT:
SUBMITTER: Hajek A
PROVIDER: S-EPMC7967618 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionA previous systematic review published in 2012 focused on the use of health services based on the Andersen model. Extending this review, we will exclusively focus on systematically synthesising longitudinal studies examining the determinants of healthcare use based on the Andersen model. Therefore, our aim of this systematic review is to provide an overview of longitudinal observational studies investigating the predictors of healthcare use explicitly using this model.Methods and analysisWe will search three electronic databases (Medline, PsycINFO and CINAHL). Furthermore, reference lists will be searched manually. Longitudinal observational studies will be investigating the determinants of healthcare use (in terms of use of outpatient physician services (like general practitioner's visits or specialist visits in total) and hospitalisation). We will exclude disease-specific samples. Data extraction will focus on methods (eg, assessment of healthcare use), sample characteristics and main findings. A suitable tool will be used to assess the study quality. Study selection, data extraction and evaluation of study quality will be conducted by two reviewers. The findings will be presented by means of figures, summary tables, narrative summaries and meta-analysis (if possible).Ethics and disseminationNo primary data will be collected. Therefore, approval by an ethics committee is not required. Our findings are planned to be published in a peer-reviewed journal.Prospero registration numberCRD42020193198.
| S-EPMC8137164 | biostudies-literature
Project description:ObjectiveTo evaluate service use, clinical outcomes and user experience related to telephone-based digital triage in urgent care.DesignSystematic review and narrative synthesis.Data sourcesMedline, Embase, CINAHL, Web of Science and Scopus were searched for literature published between 1 March 2000 and 1 April 2020.Eligibility criteria for selecting studiesStudies of any design investigating patterns of triage advice, wider service use, clinical outcomes and user experience relating to telephone based digital triage in urgent care.Data extraction and synthesisTwo reviewers extracted data and conducted quality assessments using the mixed methods appraisal tool. Narrative synthesis was used to analyse findings.ResultsThirty-one studies were included, with the majority being UK based; most investigated nurse-led digital triage (n=26). Eight evaluated the impact on wider healthcare service use following digital triage implementation, typically reporting reduction or no change in service use. Six investigated patient level service use, showing mixed findings relating to patients' adherence with triage advice. Evaluation of clinical outcomes was limited. Four studies reported on hospitalisation rates of digitally triaged patients and highlighted potential triage errors where patients appeared to have not been given sufficiently high urgency advice. Overall, service users reported high levels of satisfaction, in studies of both clinician and non-clinician led digital triage, but with some dissatisfaction over the relevance and number of triage questions.ConclusionsFurther research is needed into patient level service use, including patients' adherence with triage advice and how this influences subsequent use of services. Further evaluation of clinical outcomes using larger datasets and comparison of different digital triage systems is needed to explore consistency and safety. The safety and effectiveness of non-clinician led digital triage also needs evaluation. Such evidence should contribute to improvement of digital triage tools and service delivery.Prospero registration numberCRD42020178500.
| S-EPMC8724705 | biostudies-literature
Project description:BackgroundThere is a large treatment gap for common mental disorders (CMD), with wide variation by world region. This review identifies factors associated with formal health service utilisation for CMD in the general adult population, and compares evidence from high-income countries (HIC) with that from low-and-middle-income countries (LMIC).MethodsWe searched MEDLINE, PsycINFO, EMBASE and Scopus in May 2016. Eligibility criteria were: published in English, in peer-reviewed journals; using population-based samples; employing standardised CMD measures; measuring use of formal health services for mental health reasons by people with CMD; testing the association between this outcome and any other factor(s). Risk of bias was assessed using the adapted Mixed Methods Appraisal Tool. We synthesised the results using "best fit framework synthesis", with reference to the Andersen socio-behavioural model.ResultsFifty two studies met inclusion criteria. 46 (88%) were from HIC. Predisposing factors: There was evidence linking increased likelihood of service use with female gender; Caucasian ethnicity; higher education levels; and being unmarried; although this was not consistent across all studies. Need factors: There was consistent evidence of an association between service utilisation and self-evaluated health status; duration of symptoms; disability; comorbidity; and panic symptoms. Associations with symptom severity were frequently but less consistently reported. Enabling factors: The evidence did not support an association with income or rural residence. Inconsistent evidence was found for associations between unemployment or having health insurance and use of services. There was a lack of research from LMIC and on contextual level factors.ConclusionIn HIC, failure to seek treatment for CMD is associated with less disabling symptoms and lack of perceived need for healthcare, consistent with suggestions that "treatment gap" statistics over-estimate unmet need for care as perceived by the target population. Economic factors and urban/rural residence appear to have little effect on treatment-seeking rates. Strategies to address potential healthcare inequities for men, ethnic minorities, the young and the elderly in HIC require further evaluation. The generalisability of these findings beyond HIC is limited. Future research should examine factors associated with health service utilisation for CMD in LMIC, and the effect of health systems and neighbourhood factors.Trial registrationPROSPERO registration number: 42016046551 .
| S-EPMC6104009 | biostudies-literature
Project description:UK NHS contracts mediate the relationship between dental and medical practitioners as independent contractors, and the state which reimburses them for their services to patients. There have been successive revisions of dental and medical contracts since the 1990s alongside a change in the levels of professional dominance and accountability. Unintended consequences of the 2006 dental contract have led to plans for further reform. We set out to identify the factors which facilitate and hinder the use of contracts in this area. Previous reviews of theory have been narrative, and based on macro-theory arising from various disciplines such as economics, sociology and political science. This paper presents a systematic review and aggregative synthesis of the theories of contracting for publicly funded health care. A logic map conveys internal pathways linking competition for contracts to opportunism. We identify that whilst practitioners' responses to contract rules is a result of micro-level bargaining clarifying patients' and providers' interests, responses are also influenced by relationships with commissioners and wider personal, professional and political networks.
| S-EPMC4008934 | biostudies-literature
Project description:This study aimed to examine the prevalence of dental service utilisation in Indonesia and its association with social determinants at individual and community levels. Cross-sectional data from the 2014 Indonesian Family Life Survey (IFLS-5) was analysed. Individual independent variables included age, sex, marital status, educational attainment, economic status, health insurance, dental pain, self-reported mouth ulcers, self-rated health status, unmet healthcare needs and smoking status, while community independent variables included cognitive, structural social capital and residential area. Multilevel logistic regressions were performed to explore the associations between independent variables at different levels and the outcome of dental service utilisation. Of the total sample of 16,860 adults aged 15 years or older in our study, around 86.4% never visited a dentist. Dental service utilisation was associated with older age, female, currently not married, higher education level and economic status, health insurance, dental pain, self-reported mouth ulcers, met healthcare needs, never smoking, living in urban areas and communities with high structural social capital. Both individual and broader social determinants influenced dental service utilisation in Indonesia. These factors should be considered in the formulation of oral health policies and programmes aiming to improve dental service utilisation in the country.
| S-EPMC7432444 | biostudies-literature
Project description:To meet the current needs of researchers who perform systematic reviews in health care settings, libraries need to provide high-quality educational services for researchers as part of their systematic review services. A team of librarians with diverse skills is also important for ensuring the growth and sustainability of systematic review services. This commentary describes a new team-based systematic review service model that can transform systematic review services by providing a pathway for librarians to offer a comprehensive educational service for systematic review research in a variety of health sciences library settings.
| S-EPMC6148613 | biostudies-other
Project description:BackgroundThere is wide variation in the utilization of institutional delivery service in Ethiopia. Various socioeconomic and cultural factors affect the decision where to give birth. Although there has been a growing interest in the assessment of institutional delivery service utilization and its predictors, nationally representative evidence is scarce. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia.MethodsStudies were accessed through PubMed, Cochrane library, Web of Science, and Google Scholar. The funnel plot and Egger's regression test were used to see publication bias, and I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of institutional delivery service utilization and associated factors.ResultTwenty four studies were included in this review. The pooled prevalence of institutional delivery service utilization was 31% (95% Confidence interval (CI): 30, 31.2%; I2 =?0.00%). Attitude towards institutional delivery (Adjusted Odd Ratio (AOR)?=?2.83; 95% CI 1.35,5.92) in 3 studies, maternal age at first pregnancy (AOR?=?3.59; 95% CI 2.27,5.69) in 4 studies, residence setting (AOR?=?3.84; 95% CI 1.31, 11.25) in 7 studies, educational status (AOR?=?2.91;95% 1.88,4.52) in 5 studies, availability of information source (AOR?=?1.80;95% CI 1.16,2.78) in 6 studies, ANC follow-up (AOR?=?2.57 95% CI 1.46,4.54) in 13 studies, frequency of ANC follow up (AOR?=?4.04;95% CI 1.21,13.46) in 4 studies, knowledge on danger signs during pregnancy and benefits of institutional delivery (AOR?=?3.04;95% CI 1.76,5.24) in 11 studies and place of birth of the elder child (AOR?=?8.44;95% CI 5.75,12.39) in 4 studies were the significant predictors of institutional delivery service utilization.ConclusionThis review found that there are several modifiable factors such as empowering women through education; promoting antenatal care to prevent home delivery; increasing awareness of women through mass media and making services more accessible would likely increase utilization of institutional delivery.
| S-EPMC7296650 | biostudies-literature
Project description:BackgroundTelephone-based digital triage is widely used by services that provide urgent care. This involves a call handler or clinician using a digital triage tool to generate algorithm-based care advice, based on a patient's symptoms. Advice typically takes the form of signposting within defined levels of urgency to specific services or self-care advice. Despite wide adoption, there is limited evaluation of its impact on service user experience, service use and clinical outcomes; no previous systematic reviews have focussed on services that utilise digital triage, and its impact on these outcome areas within urgent care. This review aims to address this need, particularly now that telephone-based digital triage is well established in healthcare delivery.MethodsStudies assessing the impact of telephone-based digital triage on service user experience, health care service use and clinical outcomes will be identified through searches conducted in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus. Search terms using words relating to digital triage and urgent care settings (excluding in-hours general practice) will be used. The review will include all original study types including qualitative, quantitative and mixed methods studies; studies published in the last 20 years and studies published in English. Quality assessment of studies will be conducted using the Mixed Methods Appraisal Tool (MMAT); a narrative synthesis approach will be used to analyse and summarise findings.DiscussionThis is the first systematic review to evaluate service user experience, service use and clinical outcomes related to the use of telephone-based digital triage in urgent care settings. It will evaluate evidence from studies of wide-ranging designs. The narrative synthesis approach will enable the integration of findings to provide new insights on service delivery. Models of urgent care continue to evolve rapidly, with the emergence of self-triage tools and national help lines. Findings from this review will be presented in a practical format that can feed into the design of digital triage tools, future service design and healthcare policy.Systematic review registrationThis systematic review is registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO 2020 CRD42020178500 ).
| S-EPMC7805218 | biostudies-literature
Project description:BackgroundIatrogenic root perforations are an unfortunate accident that can occur during dental treatment and can lead to peri-radicular damage, poor treatment outcome and extraction of the tooth. The aim of this review was to analyse the occurrence and risk factors for root perforation.MethodsA systematic search of the literature was conducted in CINAHL, Cochrane, EMBASE, Medline and SCOPUS in May 2019. Additional literature was identified through a hand search. Clinical studies enrolling adults with permanent dentition were included. Single case studies and case reports were excluded. Duplicate articles were removed, titles and abstracts were screened and studies were selected according to the inclusion criteria. Data were collected and reported in accordance with PRISMA guidelines. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools.ResultsA total of 916 articles were screened, from which 47 full-text articles were analysed and 22 articles were finally included in the study. The data were analysed qualitatively because meta-analysis could not be conducted owing to lack of heterogeneity among the studies. Most of the articles were retrospective cross-sectional studies on root canal treatments performed by undergraduate students. The occurrence of perforation ranged from 0.6% to 17.6%. Risk factors for perforation included experience of the practitioner, tooth type, and tooth morphology. The risk of bias in most of the studies included was assessed as low.ConclusionsThis systematic review suggests a need for additional studies on the risk factors associated with iatrogenic root perforation as the current literature is insufficient. Educational efforts in dental schools should address the issue of perforations and provide more clinical experience prior to graduation in order to improve the clinical skills of graduates.
| S-EPMC9275354 | biostudies-literature
Project description:Background:Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia. Methods:The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5. Results:Women's inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P?=?0.02], women's age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P?=?0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P?<?0.0001] and women from rural area [OR?=?0.65;95% CI:0.50, 0.81, P?=?0.0009] were less likely associated in the use of long-acting family planning services. The odds of utilizing long acting family planning methods were high among non-government- employed women and husband [OR, 1.77; 95% CI: 1.29, 2.43, P?=?0.0004], [OR, 1.69; 95% CI: 1.33, 2.15, P?<?0.0001] respectively. Having no previous exposure to any modern family planning method [OR?=?2.29; 95%CI: 1.83, 2.86, P?<?0.00001] and women having no discussion with husband [OR?=?1.92 (95%CI: 1.50, 2.45) P?<?0.00001] were more likely associated in the utilization of long-acting family planning services. Conclusion:Lack of information and knowledge, having discussion with husband, being women of younger age, having less than five living children, being government-employed women and husband, not having electronic media, and being residents in rural area were significant barriers for underutilization of long acting family planning methods in Ethiopia. Hence, the investigators suggest that key stakeholders should design interventions strategies to avert attitudinal, cultural and informational barriers towards long-acting family planning methods. Systematic review registration:PROSPERO: 2018: CRD42018096373.The online version of this article (10.1186/s40834-019-0095-z) contains supplementary material, which is available to authorized users.
| S-EPMC6771115 | biostudies-literature