HIMT 310 : Factors influencing Utilization of Health Care : Research M

Introduction: 

Globally, people are facing challenges in accessing health care services due to significant needs for health care, which are often not adequately met (Ma, Chan & Loke, 2017). To increase the quality of human life, policy makers and providers of healthcare need to understand why individuals exploit or do not exploit health care services better. The environment globally is facing a myriad of challenges in terms of population growth, higher medical care demand, increased health problems, medical technologies advancements, and expenditure on health care (Hornborg & Crumley, 2016). As a result, governments’ most challenging objective is health care financing, particularly in developing countries.

In Australia, the underlying principle for health care is parity to universal access to most of the health care irrespective of their ability to pay (Armstrong et al., 2007). Australia has been able to achieve this as most health care systems are funded from taxation thereby promoting access to health system equity. The Australian health care system explores the concept of equal access in relation to efficiency and effectiveness (Healy, 2016). Most developing countries have their source of health care finances subjugated by the private sector as households’ payment from their pockets (Jayachandran, 2015). Australia’s universal health care system, Medicare, subsidies most medical costs in Australia. However, in remote areas such as the Northern State, access to health care is very difficult. Residents are forced to bear the cost of traveling and time to access health services.

Reforms are therefore necessary to involve more people in the scheme (Thill, 2015). Policymakers, therefore, need to comprehend the behaviors and factors which affect health care utilization in a bid to improve the service quality to attract more people to enroll in the scheme. Analyzing the factors of utilization of health care among private workers who are insured will provide a clear picture of who pays and who gets to benefit from the scheme.

Research questions

• What are the determinants of utilization of health care among private workers who are insured under Medicare in Australia?
• What are the barriers of accessing health care services for private workers who are insured under Medicare in Australia?

Research Objectives

• To identify the determinants of utilization of health care among private workers who are insured under Medicare, Australia.
• To identify the barriers for private workers who are insured to access health services under Medicare in Australia.

The scope of the study

The study will focus on private workers who are insured under Medicare in the Northern Territory in Australia. The participants will be currently employed by privately owned firms. The data will be collected from January to March 2019.

Literature review

Curtis & MacMinn (2008) carried out a study in Canada that concerned the utilization of health care in 25 years of evidence in identifying the association between utilization and status of socio-economy, demographic characteristics and controlling. The research described the pattern of utilization of health care under the insurance scheme of public health. The investigation was done with regards to specialists, physician, and utilization of hospital care from 1978 to 2003. From the data extracted, it was seen that the utilization of healthcare is growing through time. Individuals in the status best described as in the lower socio-economy were on average less likely to visit a physician compared to those individuals who are described as being in the middle socio-economic status. Individuals in the lower socio-economic status had lower utilization of specialist care compared to those with higher economic status. When it came to hospitalization, individuals who were poorer had slightly longer hospital stay compared to those in the middle and high groups of income. It was also observed that the utilization of health care by publicly insured individuals was strongly correlated with their health status.

Nguyen (2012) investigated the voluntary health insurance impact on utilization of health care in Vietnam through the use of modeling and descriptive study with secondary data. Nguyen analyzed the trend of voluntary health insurance members, expenditures, revenues, categories and utilization of health care in Vietnam from 1993 to 1997 (5 years). The study revealed that the utilization of health care trend was increasing in the 5 year period through the hospital number of visits of members of the voluntary health insurance was low compared to those with out-of-pocket payment. The study results could be used in predicting the usage rate on the basis of macro factors and could not include other factors which influence utilization of health care among individuals who are insured.

According to Li & Zhang (2013), health insurance affects the utilization of health care. The study determined the impact of insurance based on the community health on the utilization of health care in rural areas of Burkina Faso. It was revealed that individuals who were insured in the insurance scheme based on community health use outpatient services 40 percent more than the uninsured individuals. However, the rate of inpatient utilization did not change significantly. The study elucidates that groups of low-income earners were less likely to join schemes. Albeit being insured once, utilization of health care services was still lower compared to the middle and higher income groups. Health insurance was established to have a statistically significant effect on health care utilization.

Parisi et al., (2013) carried out a study in Sri Lanka on the factors which affect the utilization of health care with three common diseases; Viral Fever, Ischemic Heart Disease, and Bronchial Asthma. The respondent was randomly selected while conducting a cross-sectional descriptive survey. It was revealed that the age of a patient, expenditure on health care, monthly income of the household, family’s number of dependents and religion had a significant association with health care facilities utilization. Age, level of family income, religion and perception had a positive influence on the utilization of health services while expenditure on health care, access of health facilities, household size and the family dependent had a negative correlation with the utilization of health care.

Research methodology

Study Design

The study will use a cross-sectional descriptive quantitative design to explore the pattern of utilizing health care among privately insured workers under the Medicare at Elliot in the Northern Territory of Australia.

Study Area

The study will be conducted in Elliot town in the Northern Territory Australia. Elliot is a Northern Territory town in Australia. Halfway between Alice Springs and Darwin, the ton is in the Barkly Region, Yapurkulangu ward.

Study population and sample size

The study will be carried out on private workers who are insured under the Medicare scheme in Elliot town. The study will use a sample size of 100 survey participants.

Sampling techniques

A multi-stage sampling technique will be used in this study. Elliot town was purposely selected and the participant will be selected randomly from the total study population.

Variables

The dependent variable that will be used to measure the utilization of health care will be the frequency of accessing health facilities. Conversely, the independent variables will be marital status, gender, age, religion, occupation, educational status, family size, ethnicity, perceived traveling cost, waiting time, distance from the workplace to the health center, perceived health status, the hospitality of healthcare personnel, and presence of underlying disease or disability.

Data collection tools

The data to be used in the study is primary in nature. As a result, it will be collected using structured questionnaires. The questionnaires will be divided into section which will be able to get information from the participants on the various factors under study.

Pilot Testing

A pilot test will be carried out among students within the University. Pilot testing are vital in establishing the validity of the research based on the expert knowledge of other studies in the discipline (Dikko, 2016). The participants will be assumed to have similar characteristics as those of workers insured before the actual survey. The questionnaire will then be reviewed and attuned on the basis of the results from the pilot testing.

Data analysis

Data collected using the questionnaires will be coded and then keyed into SPSS. SPSS will be used in analyzing the data. From the data, the descriptive analysis will be derived. Moreover, the data will be used to come up with pie charts, histograms and bar charts which will provide a data representation and trends from the data. To prove the hypothesis, the data will be subjected to various statistical techniques such as ANOVA, t-test, and regression. These techniques will, therefore, be able to provide the relationships and association between the various data.

Ethical consideration

The participants will be provided with sufficient information regarding the research in order to have them make an informed decision regarding their participation. Thus, they will be free to clarifications for their opinion or withdraw any at any given time. No form of deception will be exercised as data will be collected when informed consents will be received. The information that will be given will be treated with unanimity and will be kept confidential.

Conclusion:

Access to health care is vital for the well-being of the population to ensure the nation is able to improve its economy. Through the analysis of private workers who are insured under Medicare, the report will thus provide a basis of implementing policies and reviewing the existing policies to ensure everybody is able to access and fully utilize health care services in the nation.

References:

Armstrong, B. K., Gillespie, J. A., Leeder, S. R., Rubin, G. L., & Russell, L. M. (2007). Challenges in health and health care for Australia. Medical Journal of Australia, 187(9), 485.

Curtis, L. & MacMinn, W. (2008). Health Care Utilization in Canada: Twenty-five Years of Evidence. Canadian Public Policy, xxxiv (1): 65-87.

Dikko, M. (2016). Establishing construct validity and reliability: Pilot testing of a qualitative interview for research in Takaful (Islamic insurance). The Qualitative Report, 21(3), 521-528.

Healy, J. (2016). Improving health care safety and quality: reluctant regulators. Routledge.

Hornborg, A., & Crumley, C. L. (2016). The World System and the Earth System: global socioenvironmental change and sustainability since the Neolithic. Routledge.

Jayachandran, S. (2015). Governance Challenges in Education and Health Care in Developing Countries. In The Political Economy of Good Governance. WE Upjohn Institute for Employment Research.

Li, X., & Zhang, W. (2013). The impacts of health insurance on health care utilization among the older people in China. Social science & medicine, 85, 59-65.

Ma, P. H., Chan, Z. C., & Loke, A. Y. (2017). The socio-ecological model approach to understanding barriers and facilitators to the accessing of health services by sex workers: a systematic review. AIDS and Behavior, 21(8), 2412-2438.

Nguyen-Vo, T. H. (2012). The ironies of freedom: Sex, culture, and neoliberal governance in Vietnam. University of Washington Press.

Parisi, R., Symmons, D. P., Griffiths, C. E., & Ashcroft, D. M. (2013). Global epidemiology of psoriasis: a systematic review of incidence and prevalence. Journal of Investigative Dermatology, 133(2), 377-385.

Thill, C. (2015). Listening for policy change: how the voices of disabled people shaped Australia’s National Disability Insurance Scheme. Disability & Society, 30(1), 15-28