PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Service user”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed1995

Injection drug users, crack-cocaine users, and human services utilization: an exploratory study.

Estimates of the number of people addicted to heroin and cocaine run into the millions. How these drug abusers interact with the social services system is not well understood. To gain insight into the nature and extent of such interactions, an exploratory study was conducted to gather information on the perceptions and utilization of human services by 44 drug abusers not in treatment. Twenty-nine injection drug users and 15 crack-cocaine users participated in focus group sessions and structured interviews. Participants were recruited by indigenous outreach workers in Dayton and Columbus, Ohio. Findings revealed a very high rate of service use by the drug users. The results raise questions about the role and efficacy of the social services system in identifying drug users and addressing their needs. In addition, the findings raise perplexing questions regarding the effectiveness of acquired immune deficiency syndrome risk-reduction efforts among injection drug users and crack-cocaine users.

Adult↗
PubMed1993

Predictors of in-home and out-of-home service use by family caregivers of Alzheimer's disease patients.

Few studies have examined whether the use of different types of services is predicted by different characteristics of elderly care recipients and primary kin caregivers. Most research aggregates services into a single category, thereby assuming that different services have the same predictors. This investigation differs from the aggregation approach by comparing four groups of elderly care recipients: in-home service of users, out-of-home service users, users of both in- and out-of-home services, and those who do not use services. Data come from personal interviews with 171 family caregivers of mild to moderate dementia patients who reside in the community. Using the modified Andersen framework and multiple group discriminant analysis, results show that care recipients who do not use services and those using only in-home services have inadequate informal supports, more emotionally strained caregivers, and more functionally impaired care recipients compared with users of out-of-home or both in- and out-of-home services.

Alzheimer Disease↗
PubMed2000

Is there a 'typical' consumer of obstetric services?

Each user of the maternity services will have a different service experience. The experience will vary depending on the place of birth, type of antenatal care, delivery and postnatal support. However, to be effective service providers, the provision ought to be responsive to the needs of the consumers. This paper considers the development of the maternity services, reflecting on the current environment in which the provision is delivered and attempts to characterise users of the provision to facilitate an understanding of consumer needs. This research considered primigravidae and multiparous users of the maternity provision and explored their access to information and their use of information with particular consideration of their referent groups. This study produced interesting results, not least that both primigravidae and multiparous users are prepared to abdicate responsibility for some aspects of their decision-making to medical professionals. Sub-categorisations of primigravida and multipara users and various socio-economic groups were also constructed.

Female↗
PubMed2006

The role of African-American clergy in providing informal services to drug users in the rural South: preliminary ethnographic findings.

To date, no ethnographic studies of the role of African-American clergy in providing informal services to drug users in the rural South have been reported. We use qualitative interviews with 15 African-American ministers and 26 African-American drug users in Arkansas' Mississippi River Delta region to explore this issue. All drug users reported significant religiosity, and 9 had discussed drug problems with clergy. Every minister had provided assistance to at least one drug user or their family during the previous year, including: direct counseling; referrals to treatment programs; aiding negotiations with formal institutions; and providing for basic needs. Ministers stated that clergy are not well-prepared to address drug problems, and most acknowledged a need for professional training. They also discussed barriers to education. The findings contribute to understanding rural informal drug treatment resources. They suggest that professional treatment providers should investigate the potential benefits of improving outreach efforts to assist African-American ministers engaged in drug abuse issues.

Adult↗
PubMed2000

Use of community support services by middle-aged and older patients with psychotic disorders.

OBJECTIVE: The study sought to determine the degree to which use of community services is related to predisposing, enabling, and need factors among older patients with psychotic disorders who live in the community and to assess whether high use of community services is associated with improving or declining psychopathology. METHODS: The sample consisted of 89 middle-aged and elderly community-dwelling patients with schizophrenia or other psychotic disorders. Assessments at baseline and two follow-ups at six-month intervals included measures of psychopathology, well-being, and social adjustment, in addition to the frequency of use of 17 formal community services in three categories-psychological, social, and daily living services. RESULTS: Ninety-two percent of patients reported use of community support services. The mean number of annual service contacts per patient was 36.6 for psychological services, 81 for social services, and 39.7 for daily living services. High users of psychological services were younger and experienced more severe positive psychotic symptoms and depressive symptoms. High users of social services were of higher socioeconomic status, more likely to be female, and had a longer history of psychosis, more cognitive deficits, and more severe negative psychotic and depressive symptoms. Patients who used daily living services were older, had poorer functional health status and more cognitive deficits, and had more severe negative psychotic and depressive symptoms. A trend was noted for high users of social services to experience relief from depressive symptoms over time. CONCLUSIONS: Use of community services is common among older outpatients with psychotic disorders, but its frequency varies as a function of patient characteristics.

Aged↗
PubMed2000

Out-of-pocket expenses borne by the users of obstetric services at government hospitals in Karachi, Pakistan.

OBJECTIVE: Financing health services is a challenge for health policy makers world over, especially in developing countries. Alternate mechanisms such as user fees are being proposed. However, there is a feeling that in developing countries, users of government hospitals spend appreciable personal income to obtain "free services" at these facilities. METHODS: This study aimed to measure the extent and the factors associated with of out-of-pocket expenses borne by the users of obstetric care at government hospitals. It also aimed to determine willingness of consumers to bear out of pocket expenses. It was conducted in three government hospitals in Karachi. RESULTS: Seven hundred cases were registered in the study. Sixty-five percent of them had a monthly household income of less than Rupees (Rs.) 3000. Overall, users spent mean of Rs. 590 as out-of-pocket expenses for obstetric services. Of this Rs. 330 was spent on drugs and Rs. 24 on user fees. Thirty-nine percent of the patients were willing to spend out of pocket for services provided at government hospital and 39% declined to do so. Of the patients indicating willingness to spend, 98% agreed to do so for drugs. CONCLUSION: The results suggest that considerable expenses are borne out of pocket by the users of government hospitals for supposedly "free services". If user fees are to be increased the government needs to provide services for which the people will pay, such as drugs, otherwise increase in this fees will simply add to financial burden on the users.

Adult↗
PubMed1983

Mortality in a cohort of long-term users of community psychiatric services.

A cohort of 181 users of community psychiatric services in Camberwell with at least one year's history of contact was traced for two years following a census day. Four of the eight patients who had been given a primary diagnosis of an organic condition died during this period. For the others the population-standardized mortality risk was 2.4, similar to rates previously found for in-patients with acute disorders. The causes of death were those that are common in the population. Only one suicide was recorded.

Adult↗
PubMed1987

Irregular users of dental services among Norwegian adults.

In 1979-80 a nationwide random sample of 1511 Norwegians, aged 16-79 years, were asked a series of questions about dental health and related factors (behavior, attitude, knowledge, social network, interpersonal communication, and 'health locus of control'). The purposes of the study were to describe the irregular users of dental services and to find mutable factors that could distinguish the regular from the irregular users. 17.4% of the dentate women and 21.7% of the men reported visiting the dentist less than once a year. Among the background variables, age and income/education were the most powerful predictors of use of dental services. Different patterns of behavioral characteristics were found among women as compared with men. The mutable factors that made a significant distinction between the regular and irregular users were use of interdental remedies, use of fluoride, social network, and health attitude (only among women). To a great extent, sociopsychologic and behavioral factors seemed to act through the demographic and economic variables in predicting the regularity of dental attendance.

Adolescent↗
PubMedDate not supplied

Frustrating patients: physician and patient perspectives among distressed high users of medical services.

OBJECTIVE: To identify differences between patients viewed as frustrating by their physicians and those considered typical and satisfying. DESIGN: This cross-sectional observational study focused on psychologically distressed high users of medical services. Frustrating patients were compared with typical and satisfying patients, using data from patient questionnaires, physician assessments, structured psychiatric interviews, and computerized utilization records. SETTING: Group Health Cooperative of Puget Sound, a large health maintenance organization. PATIENTS/PARTICIPANTS: Study patients were in the top decile for ambulatory visits, and bad elevated scores for anxiety, depression, and somatization. Among the 339 patients invited to participate in the study, 251 agreed, and 228 were rated by their physicians. MAIN RESULTS: A substantial proportion (37%) of the high users were viewed as frustrating by their physicians. Physicians' ratings of physical disease severity did not differ among the groups, but frustrating patients rated their own health status less favorably and reported more somatic symptoms and disabilities. The frustrating group utilized more medical services than did other distressed high utilizers. All three groups had a high prevalence of mental disorders. However, frustrating patients had higher rates of somatization and generalized anxiety disorder. CONCLUSIONS: Physicians and their frustrating patients had contrasting views of the patients' illnesses. The best predictors of physician frustration were somatization and increased medical service utilization. There is need for further research and clinical attention concerning optimal clinical management for patients with somatization.

Adult↗
PubMed1995

Repeat users of substance abuse services at a VA Medical Center.

To examine patterns of use of acute walk-in services by substance abusers, the authors studied demographic characteristics and type of substance abuse among 1,838 patients treated at a Veterans Affairs substance abuse triage unit. They found that African-American and male substance abusers appeared most likely to return for triage services. Among heroin users, the strongest predictor of return was gender. Among alcoholics, homelessness was the sole predictor of return. No predictors were found for cocaine users. The authors conclude that the relationship between return rates and type of substance abuse needs further study.

Adult↗
PubMed1998

Cost-effectiveness of intensive psychiatric community care for high users of inpatient services.

BACKGROUND: This 2-year experimental study evaluated the effectiveness and cost of 10 intensive psychiatric community care (IPCC) programs at Department of Veterans Affairs medical centers in the northeastern United States. METHODS: High users of inpatient services were randomly assigned to either IPCC or standard Department of Veterans Affairs care at 6 general medical and surgical hospitals (n=271 vs 257) and 4 neuropsychiatric hospitals (n=183 vs 162). Patient interviews every 6 months and national computerized data were used to assess clinical outcomes, health service use, health care costs, and non-health care costs. RESULTS: There was only 1 significant clinical difference between groups across follow-up periods: IPCC patients at general medical and surgical sites had higher community living skills. However, at the final interview, IPCC patients at general medical and surgical sites showed significantly lower symptoms, higher functioning, and greater satisfaction with services. Treatment with IPCC significantly reduced hospital use only at neuropsychiatric sites (320 vs 513 days, P<.001). Total societal costs, including the cost of IPCC, were lower for IPCC at neuropsychiatric sites ($82,454 vs $116,651, P<.001), but greater at general medical and surgical sites ($51,537 vs $46,491, P<.01). When 2 sites that incompletely implemented the model were dropped from the analysis, costs at general medical and surgical sites were $38 lower for IPCC (P=.26). CONCLUSIONS: At acute care hospitals, IPCC treatment is associated with greater long-term clinical improvement and, when fully implemented, is cost-neutral. At long-stay hospitals treating older, less-functional patients, it is not associated with clinical or functional improvement but generates substantial cost savings. Intensive psychiatric community care thus has beneficial, but somewhat different, outcome profiles at different types of hospitals.

Age Factors↗
PubMed2003

Radiology scheduling: preferences of users of radiologic services and impact on referral base and extension.

RATIONALE AND OBJECTIVES: To study end-user attitudes and preferences with respect to radiology scheduling systems and to assess implications for retention and extension of the referral base. A study of the institution's historical data indicated reduced satisfaction with the process of patient scheduling in recent years. METHODS: Sixty physicians who referred patients to a single, large academic radiology department received the survey. The survey was designed to identify (A) the preferred vehicle for patient scheduling (on-line versus telephone scheduling) and (B) whether ease of scheduling was a factor in physicians referring patients to other providers. Referring physicians were asked to forward the survey to any appropriate office staff member in case the latter scheduled appointments for patients. Users were asked to provide comments and suggestions for improvement. The statistical method used was the analysis of proportions. RESULTS: Thirty-three responses were received, corresponding to a return rate of 55%. Twenty-six of the 33 respondents (78.8%, P < .01) stated they were willing to try an online scheduling system; 16 of which tried the system. Twelve of the 16 (75%, P < .05) preferred the on-line application to the telephone system, stating logistical simplification as the primary reason for preference. Three (18.75%) did not consider online scheduling to be more convenient than traditional telephone scheduling. One respondent did not indicate any preference. Eleven of 33 users (33.33%, P < .001) stated that they would change radiology service providers if expectations of scheduling ease are not met. CONCLUSION: On-line scheduling applications are becoming the preferred scheduling vehicle. Augmenting their capabilities and availability can simplify the scheduling process, improve referring physician satisfaction, and provide a competitive advantage. Referrers are willing to change providers if scheduling expectations are not met.

Appointments and Schedules↗
PubMed1999

The benefits of hospital-wide picture archiving and communication systems: a survey of clinical users of radiology services.

This paper describes one element of a broad evaluation of a hospital-wide picture archiving and communication system (PACS): an assessment of the views of users of the radiology service, their major causes of dissatisfaction with the service, the incidence of image unavailability, and the consequences of images being unavailable. The principal research design was a "before and after" comparison at Hammersmith Hospital, as the hospital site introducing PACS. Several other hospitals were included in this survey, for comparison. Questionnaires were distributed several times before PACS was operational at Hammersmith, and on one occasion after. The overall response rate was 54%. The main pre-PACS radiology-related problem areas were: the non-availability of images, the non-availability of written reports when clinically required, and the time devoted by junior staff to image searching. PACS greatly reduced the perceived problem of image non-availability. But Hammersmith's problems with the availability of radiological reports still remained when PACS was operational. The time junior doctors spent in image-searching was dramatically reduced by the introduction of PACS.

Attitude of Health Personnel↗
PubMed1998

Methadone treatment in the Scottish context: outcomes of a community-based service for drug users in Lothian.

Few studies investigating the effectiveness of methadone treatment for opiate dependence have emanated from the UK. The core feature of treatment offered by Lothian Health's Community Drug Problems Service involves the prescribing of methadone by the client's general practitioner. Of a cohort of 494 daily users of opiates attending the service, 39% remained in treatment for at least 12 months. Up to 2 years in-treatment follow-up revealed significant improvement in injecting and criminal behaviour. There were no HIV seroconversions reported during the treatment period. There was no improvement in injection equipment sharing, condom use, illicit drug use or employment status. 'Satisfactory' discharge was achieved for 40% of those in treatment for at least 6 months. These results are largely consistent with the outcomes of methadone programmes elsewhere.

Adolescent↗
PubMed1997

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations.

Computer Communication Networks↗
PubMed1989

Users of a public arthritis information service and their needs.

Brief interviews were conducted with 1670 users of the Arthritis Information Service of Alabama, a statewide toll-free telephone information service. The results showed the service users were significantly (p less than 0.01) different from both the adult population and from the estimated symptomatic population of the service area. Users tended to be female, symptomatic, white, older, and better educated than the adult population. The most frequent category of need was emotional support, followed by referral, symptom/test explanation, treatment explanation, self-help method, medication, and physician-patient communication. Informational needs were significantly related to the gender, age, and the reported diagnoses of the user. Our results suggested that telephone services for health promotion may need to make special efforts to reach nonwhite and less educated persons and to provide emotional support.

Adult↗
PubMed1992

The Finnish Family Competence Study: fathers of young families as users of health care services.

STUDY OBJECT: Fathers of young families as users of health care services. DESIGN: Randomized cluster sampling and confidential questionnaires. SETTING: Maternity health care clinics (MHCCs). PARTICIPANTS: The first phase of the Finnish Family Competence Study included a total of 1,414 fathers of young families expecting their first baby. Of these, 1,279 responded to the questionnaire, the drop-out rate being 9.5%. The third phase included a total of 1,279 fathers of young families after their first baby's birth. Of these, 1,161 responded to the questionnaire, the drop-out rate now being 9.2%. VARIABLES: Basic educational level, age and occupation were used as demographic variables. Socio-economic factors were also studied. The use of health services was examined with questions related to the quality and the frequency of use of these services. The study also dealt with the use of medicines and health food products. RESULTS: The frequency of use of health services was related to the respondent's occupation: industrial and primary production employees were the most frequent users and professionals and services sector employees the least frequent users. So-called soft medicines (vitamins, micronutrients, etc.) were most frequently used by the respondents with the highest level of education. In the use of other medicines no differences occurred between education groups.

Adolescent↗