Dr Hidayathulla Shaikh, Lecturer, College of Dentistry, Majmaah University.

Objectives Define Utilization. Explain the need for Dental care. Discuss the factors affecting in health services utilization. Discuss triggering factors for the utilization of health services.

Utilization Defined as “the actual attendance by the members of the public at health care facilities to receive care’’. The factors which influence an individual to utilize a health service are – 1) Individual must feel susceptible to disease. 2) Individual must feel that the disease is potentially serious. 3) Individual must feel that the course of action that will prevent or alleviate the disease is available

Need for Dental care Different types of need for dental care are – a) Normative need –  It is the requirement for care as determined by expert opinion.

b) Felt need (Perceived need) – It the requirement of care as determined by the patient or public.

c) Expressed need - Demands for health care, it arises out of attempts by members of the public to seek attention for their perceived needs.

Factors Affecting Health Services Utilization 1) Age - Utilization is low for the youngest age group, highest for the teenage to young adults, followed by a constant decline for the remaining ages.

2) Gender – Females tend to utilize health services more then males.

3) Education – The utilization rate increases with increase in the level of education. The education level of head of the family is important factor to say how frequently the family members will utilize health services.

4) Socio economic status – People with high socioeconomic status utilize health services more often than the people of low socioeconomic status.

5) Occupation – Persons in professional occupations visits their health care providers more frequently than semi or non skilled workers.

6) Residence – People from urban areas utilize more health services than rural areas. Utilization also varies with the size of the community, larger the community greater the utilization rate.

7) Socio-cultural factors – Individual presents himself to treatment depends on his knowledge, anxiety, fear of doctor, financial and psychological factors. Perceptions particularly negative attitude and beliefs, affect peoples response to illness and utilization of health services.

8) Organizational factors – The way the health services are organized play an important role in determining utilization. If change is to be brought, a mere increase in manpower is not enough, it is necessary to change the basis of system of delivery.

9) Cost of Health services – Cost is the major barrier to utilization of health services. Even when cost barriers are reduced wide variations still remain in the utilization of health services Because social, cultural and demographic factors are also important determinants.

Triggering Factors for the Utilization of Health Services. Many people suffer from pain and other symptoms for considerable length of time before consulting professional. Often symptoms were tolerated until some events/factors triggers utilization of health services.

1) The occurrence of interpersonal crisis – A change in personal relationship, such as domestic crisis.

2) Perceived interference with social or personal relations - Symptoms that interfere with normal social relations may create more concern. Ex – toothache preventing someone from going on holiday.

3) Perceived interference with vocational or physical activity – Symptoms that interfere with the normal activities of daily life will be evaluated as abnormal.

4) Temporalizing of symptomatology – This involves the patient setting a deadline by deciding that he will consult a doctor, if symptoms do not disappear by certain date.

5) Sanctioning – This involves the pressure from friends and relatives to use health services. The process of consultation with friends is described as accessing the ‘lay referral network’. If a person has friends and relatives for advice, than a professional is consulted sooner and health services will be utilized.