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    Change in Utilization of Health Services and its Affecting Factors in Kayseri City Center: A Comparative Population-Based Cross-Sectional Study in 2004 and 2017
    (Türkiye Klinikleri, 2023) Şenol, Vesile; Elmalı, Ferhan; Çetinkaya, Fevziye; Naçar, Melis; Yalap, Rukiye
    Objective: This study aimed to examine the change in health service use and its affecting factors by comparing the findings of 2 studies conducted at different times, with the same data collection tools, in the same health service region. Material and Methods: The first cross-sectional study was conducted in 2004, in urban areas in Kayseri, with 501 households and 1,880 people in Primary Health Centers. The second was carried out in 2017, in 30 Family Health Centers, with 801 households and 2,253 people. The data were collected by the face-to-face interview method using a questionnaire. In statistical analysis, mean±standard deviation, median (Q1-Q3), Mann-Whitney U, Kruskal-Wallis, Pearson ?2, logistic regression analysis were used. The value p<0.05 was accepted as statistically significant. Results: The rate of health service utilization (HSU) increased from 79.6% to 84.8%, the average number of visits to physicians per person increased from 4.9 to 6.9. While the proportion of primary HSU increased to 45.8%, requests for visits to public hospital decreased to 26.4%. Healthcare use was significantly higher in male gender (2.2-2.3 times), 65 years and older (2.8-3.2 times), in people with good income (1.8-1.5 times), and in those with negative health perception (1.8-1.9 times). Conclusion: There has been a significant improvement in HSU parameters, particularly in Primary Health Care Centers services. Male gender, good level income, advanced age (?65), and negative health perception are the main determinants of healthcare use. These results require a better understanding of the factors that make access to the health facilities difficult and the development of strategies that ensure fair use of health services.
  • Küçük Resim
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    Changing perceptions of general health in the Kayseri Province, Turkey in 2004 and 2017: A population-based study
    (frontiers, 2023) Şenol, Vesile; Elmalı, Ferhan; Çetinkaya, Fevziye; Naçar, Melis
    Aim: Self-rated health (SRH) and health-related quality of life (HRQoL) have closely related outcomes inmeasuring general health status in community-based studies. The aimof this study is to determine changes in the self-perceived overall health of people and a?????ected factors by comparing the findings of two studies conducted in the same research area. Methods: Both studies were conducted using the same measurement tools in households determined by random sampling techniques in the same research areas. The first and second studies were conducted with 1,304 and 1,533 people residing in 501 and 801 households in 2004 and 2017, respectively. The demographic data form, the Nottingham Health Profile (NHP), and a single-item SRH questionnaire were used for data collection. Results: The rate of good SRH increased from 56% to 70% while the average NHP score decreased from 30.87 to 20.34. The predictors of negative health perceptions were the presence of chronic diseases (OR 3.4–2.7-times higher), being female (OR.1.4–1.5 times higher), and the completion of primary education only (OR. 2.7–2.8 times higher) both 2004 and 2017. Living 500–1,000m from the nearest healthcare facility was the main protective variable against poor SRH. Conclusions: Good SRH and HRQoL have increased significantly over time. Chronic diseases, education, and gender are the strongest predictors of poor SRH.