How, when, and where to measure and utilize service delivery is a major challenge within the health system. Utilization can, much like supply and need-based, be broken down into two parts; it starts with what we know and then proceeds to what are the gaps.
Typically the 'what we know' for service utilization is looking at retrospective data (billing data, discharge abstract data, insurance claims, private clinic data, EMR data, other) to understand what services folks are using and more importantly, what services are being recommended/perscribed.
In addition to data, we also use the Andersen Behavioural Model (figure 1) - widely used by researchers to determine healthcare service utilization across a variety of populations. This drives the second part of HSU planning: what are the gaps?
Utilization of non-users can also be tracked based on their self-reported health status (source) - a great example of how health service utilization dovetails into needs-based planning.
Utilization encompasses a variety of dimensions, reflecting both the demand and supply sides of healthcare delivery. Here are several key aspects:
Health workforce providers view utilization as a measure of how accessible health services are to the population. This includes the availability of healthcare facilities, the distribution and adequacy of healthcare professionals, and the accessibility of specialized care. Providers assess whether patients can easily access services when needed, without excessive wait times or barriers such as distance, cost, or lack of information.
The quality of services provided is a critical and oft forgotten or hard to measure component. High utilization rates are not inherently positive if they do not correspond with high-quality care. Increased utilization should lead to improved health outcomes, which require adherence to evidence-based practices, continual education, and training, as well as adequate staffing levels and resources.
From the provider's perspective, efficient use of resources is vital for sustainable health service utilization. This involves managing patient flows effectively, optimizing scheduling, reducing unnecessary procedures, and ensuring that healthcare professionals are working at the top of their license. Efficient resource allocation helps in addressing overuse, underuse, or misuse of health services.
Health workforce providers consider patient satisfaction and engagement as indicators of successful health service utilization. Providers aim to deliver patient-centered care that meets the needs and preferences of patients, encourages their active participation in health decisions, and ultimately improves their health and well-being.
Providers are increasingly recognizing the importance of equity in health service utilization. This involves ensuring that all individuals, regardless of their socio-economic status, ethnicity, gender, or geographic location, have equitable access to health services and receive care that meets their specific health needs.
Health workforce providers understand that health service utilization patterns change over time due to factors like population aging, the emergence of new health technologies, and shifts in disease prevalence. Providers must be adaptable, continuously assessing and responding to these changing needs to ensure that services remain relevant and effective.
Effective utilization involves not just the provision of individual health services but also their integration within the broader health system. Providers strive for a coordinated approach that ensures continuity of care across different settings and services, such as primary care, specialty care, and community-based services, enhancing the overall efficiency and effectiveness of health service delivery.
Health workforce providers increasingly rely on data and analytics to understand and improve health service utilization. This includes the use of electronic health records, health information systems, and other data sources to monitor trends, identify gaps in service delivery, and inform policy and practice improvements.
In summary, Health Service Utilization from the health workforce providers' perspective is a multi-faceted concept that encompasses the delivery, quality, efficiency, and equity of healthcare services. It involves a continuous effort to meet the evolving health needs of the population, ensure patient satisfaction, and achieve better health outcomes within a sustainable and equitable framework.
