Determinants of Utilization of Health Services Provided for Children with Cerebral Palsy in Jordan
- 26 Downloads
Enhancing services utilization for children with cerebral palsy is a national priority particularly in middle and low income countries. Based on Andersen’s (1995) Behavioral Model of Health Services Use and previous research findings, a conceptual model was developed to identify child, family, and service determinants of utilization of services by children with cerebral palsy in Jordan. 1 hundred and 16 families of children with cerebral palsy agreed to participate in the study. Children were 4.6 ± 4.3 years of age. The most common types of cerebral palsy were spastic quadriplegia followed by spastic diplegia. Data were collected in 2 sessions. Physiotherapists’ research assistants administered the Gross Motor Classification System, the Gross Motor Function Measure-66-Item Set Version, Child Information Questionnaire, the Family Support Scale, the Family Resources Scale, Family Information Questionnaire, Services Questionnaire, and the Measure of Processes of Care-20 Item Version. Hierarchical multiple regression analysis by blocks was used to determine the predictors of the utilization of services. The model explained 57.5% of the variance in access to services. Satisfaction with services was the most influential determinant of utilization of services followed by family resources, child needs for services, associated health problems, father employment, and processes of care. Professionals and policy makers are encouraged to attend to parents’ satisfaction with services, processes of care, and family resources as key indicators of improving access and utilization of services by families of children with cerebral palsy.
KeywordsUtilization of service Cerebral palsy Jordan Anderson model Satisfaction Children
The authors would like to thank the participant families and children for their time and commitment. A special gratitude for the participant sites including Albasheer Hospital, the Cerebral Palsy Foundation, and the University of Jordan Hospital for support during data collection.
All authors participated in designing the study. NA and MS supervised data collection, NA and CD performed data analysis and prepared the first draft of the manuscript. All authors edited and approved the final manuscript.
Compliance with Ethical Standards
This study is funded by the Deanship of Scientific Research – The University of Jordan Amman- Jordan.
This study was approved by the Institutional Review Boards of the University of Jordan Hospital and the Ministry of Health.
Informed consent was obtained from all participants included in the study.
Conflict of Interests
The authors declare no conflict of interest.
- Almasri, N. A., Saleh, M., & Dunst, C. J. (2014b). Psychometric properties of the Arabic family support scale for families of children and youth with cerebral palsy in Jordan. Journal of Intellectual and Developmental Disability, 39(3), 223–232. https://doi.org/10.3109/13668250.2014.914474.CrossRefGoogle Scholar
- Babitsch, B., Gohl, D., & von Lengerke, T. (2012). Re-revisiting Andersen’s behavioral model of health services use: A systematic review of studies from 1998-2011. Psycho-Social Medicine, 9, Doc11. https://doi.org/10.3205/psm000089.
- Coakes S. J. (2005). SPSS: Analysis without anguish: Version 12.0 for windows. Queensland: Wiley.Google Scholar
- Dunst, C. J., & Leet, H. E. (1987). Measuring the adequacy of resources in households with young children. Child: Care, Health and Development., 13, 111–125. https://doi.org/10.1111/j.1365-2214.1987.tb00528.x.Google Scholar
- Dunst, C., Jenkins, V., & Trivette, C. (1984). The family support scale: Reliability and validity. Journal of Individual Family and Community Wellness.Google Scholar
- Elrod, C. S., & DeJong, G. (2008). Determinants of utilization of physical rehabilitation Services for Persons with Chronic and Disabling Conditions: An exploratory study. Archives of Physical Medicine and Rehabilitation, 89(1), 114–120. https://doi.org/10.1016/j.apmr.2007.08.122.CrossRefGoogle Scholar
- McCusker, J., Karp, I., Cardin, S., Durand, P., & Morin, J. (2003). Determinants of emergency department visits by older adults: A systematic review. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 10(12), 1362–1370 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14644789.CrossRefGoogle Scholar
- Meehan, E. M., Reid, S. M., Williams, K. J., Freed, G. L., Sewell, J. R., & Reddihough, D. S. (2016). Medical service use in children with cerebral palsy: The role of child and family factors characteristics. Journal of Paediatrics and Child Health, 52, 621–627. https://doi.org/10.1111/jpc.13163.CrossRefGoogle Scholar
- Ministry of Health. (2017). Annual Report for the year ended 30 June 2017. Willington. Retrieved from https://www.health.govt.nz/publication/annual-report-year-ending-30-june-2017.
- Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine and Child Neurology, 39(4), 214–223 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9183258.CrossRefGoogle Scholar
- Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Hafizur Rahman, M. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences. https://doi.org/10.1196/annals.1425.011.
- Russell, D. J., Avery, L. M., Walter, S. D., Hanna, S. E., Bartlett, D. J., Rosenbaum, P. L., et al. (2010). Development and validation of item sets to improve efficiency of administration of the 66-item gross motor function measure in children with cerebral palsy. Developmental Medicine and Child Neurology, 52(2), e48–e54. https://doi.org/10.1111/j.1469-8749.2009.03481.x.CrossRefGoogle Scholar
- WHO. (2006). Health system profile - Jordan. Cairo, Eygpt. Retrieved from www.emro.who.int.
- WHO. (2013). Research for Universal Health Coverage. Retrieved from www.who.int/about/licensing/copyright_form/en/index.html.