Initial thoughts on a model development explaining health care utilisation
While reading the 1987 classic text by Ronald Andersen on behavioural model of health care utilization and health care access, I wonder how he tied it all together in the sixties when he first drafted his behavioural model. The challenge in our times I guess is the issue around environment, and the new age of informaiton, technology and devices.
If one were to think of explaining how and why we use health services and pay for them, and indeed, what determine our access to health care throughout our life span, how would one go about it?
It boggles my mind what really goes on. What would be a reasonable way to explain the health care utilization pattern? From a purely health policy perspective, how does one tie together the concepts of health, the issues around who accesses healthcare and how, access to health care as health and illness develop across the life span of a person, and the role of physical environment.
- What role does interaction with physical environment play in my access and utilization of health care services?
- Does the pattern of my accessing health care services (rather utilization of health care services vary) over time as my life story evolves?
- As my physical function changes over time?Does it matter how I was born, how I was raised, how I got my nutitional needs served in my infant-youth days the environment I was in?
Does the utilization of health services, the health outcomes matter and depend on them?
- Where are the evidences that they do?
At some point a novel model will emerge to develop a model of health care utilization and identify a measure of access based on the role of environmental variables.
_That_ may well be the fifth phase of the health care utilization. However, there are other issues around. I think the current age is the age of information and I wonder if anyone has worked out a model that incorporates how information dissemination and informaiton technology and its usage has affected or impacted the health care utilization and how all of that affects and impacts health care usage and access?
Arsenic toxicity is a case in point. Being exposed to arsenic in groundwater definitely affects health care usage pattern and additionally it also explains to some extent how utilisation and access to care matters. I need to get my head around this for a while and come up with a dynamic model that:
1) Explains or predicts health care utilization
2) TAkes into account the issues around nutrition, diet, arsenic toxicity and arsenic metabolism and the role that elucidation of multiple variables take to explain usage
3) Extend the scope of the Andesen model to incorporate all of these features and more to show and extend the policy debates around them