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Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil

BACKGROUND: The current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service dema...

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Autores principales: Guimarães, Djalma S, Soares, Eduardo JO, Júnior, Gileno Ferraz, Medeiros, Denise D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339295/
https://www.ncbi.nlm.nih.gov/pubmed/25885287
http://dx.doi.org/10.1186/s12913-015-0728-0
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author Guimarães, Djalma S
Soares, Eduardo JO
Júnior, Gileno Ferraz
Medeiros, Denise D
author_facet Guimarães, Djalma S
Soares, Eduardo JO
Júnior, Gileno Ferraz
Medeiros, Denise D
author_sort Guimarães, Djalma S
collection PubMed
description BACKGROUND: The current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service demand determinants from data on telephone calls made to a medical advice call centre. METHODS: This study used a Brazilian medical advice call centre data sample in the period of November and December 2012 (n = 19690), which supplied data on the user’s initial request, the physician’s recommendation, information on the patient and circumstances (the day and time of the day of the telephone call). The convergence between user intent and medical recommendation consists in adequate demand; otherwise the divergence consists in an inadequate one. In this way, using a logistic regression model, the critical factors that determine inappropriate health services request could be estimated. RESULTS: In general, the user’s initial intent is the most critical for the inappropriate health system demand occurrence: the greater the complexity of the patient’s initial intent, the greater the chance the intent is wrong: (OR: 1.160; 95% CI: 1.113-1.210). With regard to the social characteristics, men are more likely to make inappropriate requests (OR: 1.102; 95% CI: 1038-1169); as well as youngsters are more likely to use the system incorrectly (OR = .993; 95% CI: .992 - .994). Regarding the circumstances (day and time of the call), requests in the final hours of the day and on days close to the weekend are more likely to be the inappropriate ones (OR: 1.082 for each six hour increase; 95% CI: 1.049-1.116) and weekday (OR: 1.017 for each day increase; 95% CI: 1.002-1.032). CONCLUSIONS: The critical profile for the inappropriate use occurrence consists of males and youngsters, who use the health service in the final hours of the day and at weekends, and mainly want to use more complex services. A practical implication of this research is to provide health systems managers, supporting information to the most critical users in order to assist them in making a decision when asking for health care.
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spelling pubmed-43392952015-02-26 Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil Guimarães, Djalma S Soares, Eduardo JO Júnior, Gileno Ferraz Medeiros, Denise D BMC Health Serv Res Research Article BACKGROUND: The current economic and social context has required health systems to provide top quality services and to be efficient in controlling costs. An obstacle to achieve these goals is the inappropriate health services demand. This study aims to present these inappropriate health service demand determinants from data on telephone calls made to a medical advice call centre. METHODS: This study used a Brazilian medical advice call centre data sample in the period of November and December 2012 (n = 19690), which supplied data on the user’s initial request, the physician’s recommendation, information on the patient and circumstances (the day and time of the day of the telephone call). The convergence between user intent and medical recommendation consists in adequate demand; otherwise the divergence consists in an inadequate one. In this way, using a logistic regression model, the critical factors that determine inappropriate health services request could be estimated. RESULTS: In general, the user’s initial intent is the most critical for the inappropriate health system demand occurrence: the greater the complexity of the patient’s initial intent, the greater the chance the intent is wrong: (OR: 1.160; 95% CI: 1.113-1.210). With regard to the social characteristics, men are more likely to make inappropriate requests (OR: 1.102; 95% CI: 1038-1169); as well as youngsters are more likely to use the system incorrectly (OR = .993; 95% CI: .992 - .994). Regarding the circumstances (day and time of the call), requests in the final hours of the day and on days close to the weekend are more likely to be the inappropriate ones (OR: 1.082 for each six hour increase; 95% CI: 1.049-1.116) and weekday (OR: 1.017 for each day increase; 95% CI: 1.002-1.032). CONCLUSIONS: The critical profile for the inappropriate use occurrence consists of males and youngsters, who use the health service in the final hours of the day and at weekends, and mainly want to use more complex services. A practical implication of this research is to provide health systems managers, supporting information to the most critical users in order to assist them in making a decision when asking for health care. BioMed Central 2015-02-18 /pmc/articles/PMC4339295/ /pubmed/25885287 http://dx.doi.org/10.1186/s12913-015-0728-0 Text en © Guimarães et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Guimarães, Djalma S
Soares, Eduardo JO
Júnior, Gileno Ferraz
Medeiros, Denise D
Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title_full Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title_fullStr Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title_full_unstemmed Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title_short Attributes and circumstances that induce inappropriate health services demand: a study of the health sector in Brazil
title_sort attributes and circumstances that induce inappropriate health services demand: a study of the health sector in brazil
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339295/
https://www.ncbi.nlm.nih.gov/pubmed/25885287
http://dx.doi.org/10.1186/s12913-015-0728-0
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