SoleimanvandiAzar Neda, Mohaqeqi Kamal Seyed Hossein, Sajjadi Homeira, Ghaedamini Harouni Gholamreza, Karimi Salah Eddin, Djalalinia Shirin, Setareh Forouzan Ameneh
Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Iran J Med Sci. 2020 Nov;45(6):405-424. doi: 10.30476/ijms.2020.85028.1481.
The present review focuses on identifying factors contributing to health service utilization (HSU) among the general adult population according to Anderson's behavioral model.
Published articles in English on factors related to HSU were identified by systematically probing the Web of Science, MEDLINE (via PubMed research engine), and Scopus databases between January 2008 and July 2018, in accordance with the PRISMA guidelines. The search terms related to HSU were combined with terms for determinants by Boolean operators AND and OR. The database search yielded 2530 papers. Furthermore, we could find 13 additional studies following a manual search we carried out on the relevant reference lists.
Thirty-seven eligible studies were included in this review, and the determinants of HSU were categorized as predisposing, enabling, and need factors according to Andersen's model of HSU. The results demonstrated that all predisposing, enabling, and need factors influence HSU. In most studies, the female gender, being married, older age, and being unemployed were positively correlated with increased HSU. However, evidence was found regarding the associations between education levels, regions of residence, and HSU. Several studies reported that a higher education level was related to HSU. Higher incomes and being insured, also, significantly increased the likelihood of HSU.
This review has identified the importance of predisposing, enabling, and need factors, which influence outpatient HSU. The prediction of prospective demands is a major component of planning in health services since, through this measure, we make sure that the existing resources are provided in the most efficient and effective way.
本综述聚焦于根据安德森行为模型确定普通成年人群中影响卫生服务利用（HSU）的因素。
根据PRISMA指南，通过系统检索2008年1月至2018年7月期间的科学网、MEDLINE（通过PubMed研究引擎）和Scopus数据库，识别以英文发表的与HSU相关因素的文章。与HSU相关的检索词通过布尔运算符AND和OR与决定因素的检索词相结合。数据库检索得到2530篇论文。此外，在对相关参考文献列表进行人工检索后，我们又找到了13项研究。
本综述纳入了37项符合条件的研究，HSU的决定因素根据安德森的HSU模型分为易患因素、促成因素和需求因素。结果表明，所有易患因素、促成因素和需求因素均影响HSU。在大多数研究中，女性、已婚、年龄较大和失业与HSU增加呈正相关。然而，关于教育水平、居住地区与HSU之间的关联有证据可寻。几项研究报告称，较高的教育水平与HSU有关。较高的收入和参保也显著增加了HSU的可能性。
本综述确定了易患因素、促成因素和需求因素的重要性，这些因素影响门诊HSU。前瞻性需求预测是卫生服务规划的一个主要组成部分，因为通过这一措施，我们确保以最有效和高效的方式提供现有资源。
