Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

Background: Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.----- Methods: Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).----- Results: The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.----- Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

Private health insurance status and utilisation of dental services in Australia

This article focuses on the relationship between private insurance status and dental service utilisation in Australia using data between 1995 and 2001. This article employs joint maximum likelihood to estimate models of time since last dental visit treating private ancillary health insurance (PAHI) as endogenous. The sensitivity of results to the choice between two different but related types of instrumental variables is examined. We find robust evidence in both 1995 and 2001 that individuals with a PAHI policy make significantly more frequent dental consultations relative to those without such coverage. A comparison of the 1995 and 2001 results, however, suggests that there has been an increasing role of PAHI in terms of the frequency of dental consultations over time. This seems intuitive given the trends in the price of unsubsidised private dental consultations. In terms of policy, our results suggest that while government measures to increase private health insurance coverage in Australia has been successful to a significant degree, it may have come at some cost in terms of socio-economic inequality as the privately insured are provided much better access to care and financial protection.

Utilisation of early childhood education and care services in a nationally representative sample of Australian children: A focus on disadvantage

ATTENDANCE IN HIGH -QUALITY early childhood education and care (ECEC) has been shown to have a positive influence on young children’s development and life chances, especially for those children from disadvantaged backgrounds. A number of government policies are in place, both internationally and in Australia, to support these children’s use of ECEC services. But to what extent do Australia’s most vulnerable children use ECEC? Drawing on data from Growing up in Australia: The longitudinal study of Australian children (LSAC) this paper demonstrates that children from a range of disadvantaged groups do use ECEC. However, based on more in-depth analyses using a Disadvantage Index, the paper also shows that children with multiple indicators of disadvantage were more likely to be in exclusive parental care, less likely to be using preschool and using fewer hours of care than their peers. These findings suggest that there may be barriers to ECEC utilisation for children and families for whom ECEC potentially has the most benefit.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

Copépodes pélagiques du plateau ivoirien. 2 - Utilisation de l'arbre de longueur minimum dans le classement des récoltes

The minimum spanning tree algorithm is used to classify two sets of planktonic copepod samples. This algorithm links the samples the distance of which is minimum, without doing a loop, so that the sum of the segment lengths is minimum. The authors estimated the distance between samples by 2 different ways: by a coefficient of association the Jaccard's index - and by the x2 distance. Jaccard's index is not retained but the use of the x2 distance allows comparison with the 'analyse factorielle des correspondances'. The results are discussed from an ecological point of view.

Copépodes pélagiques du plateau ivoirien. Utilisation de I'analyse des correspondances dans l'étude des variations saisonnières

Several 'analyses factorielles des correspondences' were used with the numerical data of planktonic copepods issued from a 1 year sampling programme at different stations of the Ivorian shelf. The main results were the following: (1) 'Ecological seasons' approximately corresponding to hydrological seasons may be defined for planktonic populations. (2) Each 'season' is characterized by one group of species, whose maximum abundance occurs in this period. (3) The same definition of ecological season is obtained whether all species present are used or whether only the most important ones are used. (4) The first principal axes may be interpreted as temperature and salinity or as the station's distance from shore.

Utilisation de la Calorimétrie à Titrage Isotherme pour l'étude des interactions entre (bio)molécules

info:eu-repo/semantics/published

Caractérisation des matériaux latéritiques pour une meilleure utilisation en Afrique

In spite of the fact that the laterite masonry was often used for building, during the colonial period, the laterite rock is rarely studied. To resolve the economic and environmental problems, concerning the concrete or cinder block construction in Africa, this material can be again a local resource. The objective is to determine the hydro-thermo-mechanical properties of laterite rocks linking with the local geological conditions, to investigate the possibilities to be used in construction housing, sufficiently able to resist to limited loads and to give thermal comfort inside. Some preliminary results are presented here.

Evaluation éthique en psychologie : une utilisation respectueuse des différents instruments psychométriques

Trois psychologues de l'Université de Lausanne, Sophie Perdrix, Linda Charvoz et Jérôme Rossier, abordent dans leur article la relation complexe que le psychologue entretient avec les évaluations psychologiques. Ils plaident en faveur d'une utilisation respectueuse des différences individuelles des instruments d'évaluation et mettent en garde contre leurs aspects réductionnistes.