Foets M, Berghmans F, Janssens L
Soc Sci Med. 1985;20(3):181-90. doi: 10.1016/0277-9536(85)90230-8.
The article consists of two major parts. In the Introduction a general overview is given of the Primary Health Care Project, carried out in Belgium from 1975 to 1978 in the broader framework of a large National Project in the Social Sciences. An explanation is given of the scope of the study, its method and sampling. Since the very broad study design, it was decided to make a selection of interesting results. An overview is given of the most relevant data with respect to the utilization of health care services and of medicines. After a short clarification of the concept of utilization behaviour, some data are presented in order to describe the use of medical services and the consumption of medicines. Secondly an attempt is made to explain utilization behaviour. For the explanatory model used in this project, the WHO-model functioned as an important source of inspiration. In this way it surmounted the limitations of much previous research. This model included variables on the level of the individual-perceived morbidity, predisposing factors and enabling factors-as well as system variables--such as degree of urbanization, proximity and the way of functioning of the medical supply. The research results have successfully shown that: there is a strong relationship between perceived presence and perceived seriousness of morbidity on the one hand, utilization behaviour on the other hand; the health perspective (including medical knowledge, values and attitudes) seems to have a differential influence on utilization behaviour, depending on age and social background of the respondent; the inclusion of socio-structural variables is an innovation in the Belgian health care research. The hypothetical character of the relationships found here is largely supported by the research simultaneously conducted in the French-speaking region of Belgium; accessibility and socialization are factors having a clear influence on the use of general practice services. The importance of the presence and the organization of the supply in the explanation of utilization behaviour is partly confirmed.
本文由两个主要部分组成。在引言部分，对1975年至1978年在比利时开展的初级卫生保健项目进行了总体概述，该项目是在社会科学领域一个大型国家项目的更广泛框架内进行的。说明了研究的范围、方法和抽样情况。由于研究设计非常宽泛，因此决定挑选一些有趣的结果。概述了与医疗服务利用和药品相关的最相关数据。在对利用行为的概念进行简短澄清之后，呈现了一些数据以描述医疗服务的使用和药品的消费情况。其次，尝试解释利用行为。对于本项目中使用的解释模型，世界卫生组织的模型起到了重要的启发作用。通过这种方式，它克服了许多先前研究的局限性。该模型包括个体感知发病率水平、易患因素和促成因素等变量，以及系统变量，如城市化程度、距离和医疗供应的运作方式。研究结果成功表明：一方面，感知到的疾病存在和严重程度与另一方面的利用行为之间存在密切关系；健康观念（包括医学知识、价值观和态度）似乎对利用行为有不同的影响，这取决于受访者的年龄和社会背景；纳入社会结构变量是比利时医疗保健研究中的一项创新。这里发现的关系的假设性质在比利时法语区同时进行的研究中得到了很大程度的支持；可及性和社会化是对全科医疗服务使用有明显影响的因素。供应的存在和组织在解释利用行为方面的重要性得到了部分证实。
