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Ronald Andersens Behavioral Model of health services tili!ation " R# $%& 'a(il) r*an Research Linda "ga(eduru+ R",B#" #tate niversit) Helene 'uld #chool of "ursing March %/+ &/%01

The Field of study: #ociolog)

BEHAVIORAL THEORY & Theorist: Ronald M1 Andersen+ 2h1 31 develo.ed the Behavioral Model in %4561 He is the 7asser(an 2rofessor E(eritus in the -LA of Health #ervices and #ociolog)1 He 8as the chair.erson for the of health services at -LA and a .rofessor at the niversit) of -hicago+ occu.)ing a .osition as the director of the center for health ad(inistration studies and the 9raduate 2rogra( for ten )ears of Health #ervices ;3H#<+ &//4=1 3r1 Andersens Behavioral Model of Health #ervices se has *een utili!ed as a fra(e8or> for utili!ation and cost studies a(ong (inorities+ lo8 inco(e+ the elderl)+ children+ 8o(en+ and ho(eless and oral health1 He has *een involved in three surve)s of access to care and .ro(otion+ and has 8ritten &$ *oo>s and &?/ articles :3H#+ &//4=1 He is a (e(*er of the Institute of Medicine and 8as the chair.erson for the Medical #ociolog) #ection of the A(erican #ociological Association1 3r1 Andersen is the reci.ient of the 3istinguished Medical #ociologist Leo 91 Reeder A8ard+ the 3istinguish Investigator career A8ard Association for Health #ervices Research+ and the Ba@ter Allegiance 'oundation Health services research 2ri!e :3H#+ &//4=1
'igure %:

Main concepts or propositions, and how related:

1. Characteristics of the healthcare delivery system: a. Health policy: Evaluates the effects of health .olic)1 If the govern(ent intends to

lo8er to*acco usage+ the .u*lic can *e (otivated to sto.+ or at (ost to decrease their s(o>ing+ if s(o>ing is *an in 8or>.laces and .u*lic .laces1 -reating la8s *anning to*acco sales to (inors and a*olishing the introduction of to*acco vending (achines can (erge to reduce access to to*acco a(ong adolescence+ and (a) serve to discourage their e@.eri(entation 8ith to*acco1
b. Resources: It involves the volu(e and distri*ution of la*or and ca.ital+ as 8ell as+

different >inds and t).es of healthcare availa*le1 'or instance+ a .ractitioner (a) infor( their .atient that the) can reduce their ris> of cardiovascular disease and dia*etes through controlling the a(ount of fat and sugar in their diet1 But the healthcare .ersonnel and clinic 8ill (a>e the(selves availa*le for dia*etic and *lood .ressure screening1
c. Organization: The adeAuac) of la*or in deter(ining an individual usage of health

services1 The different .rocess an individual has to ta>e to access the healthcare s)ste( and the structure of the .atient is going to receive after entr) into the healthcare s)ste(+ such as 8aiting ti(e+ travel ti(e+ and 8ho( the .atient sees1
2. Characteristics of the population at risk: a. Predisposing component: These are the varia*les that i(.ede an individual fro(

using healthcare services+ such as age+ gender+ social structure :education+ race+ religion+ and occu.ation=+ culture+ health and illness values etc1

b. Enabling component: These are resources a .erson has availa*le (a) *e individuall)

:inco(e+ self,efficac)+ self regulation+ the locus of control= or 8ithin the fa(il)+ the co((unit)+ and insurance coverage1 -o((unit) can *e ur*an+ rural+ region+ social su..ort+ and attitude *) others to8ards illness1 'or e@a(.le+ a fa(il) health .ractitioner (a) 8ant their client to increase their levels of .h)sical activit)1 2ersons could have a *etter .ossi*ilit) of *eco(ing involved in regular e@ercise their co((unit) has availa*le recreation centers+ .ar>s+ and s8i((ing .ools1 If their neigh*orhood is safe and clean+ the) (ight *e (ore .rone to ta>e u. regular 8al>ing+ roller*lading+ Bogging+ or *i>e riding1 Additionall)+ .a)(ent of child care 8hile e@ercising+ .a)(ent fees for recreation centers and other s.orts facilities+ and 8ill s8a) the afforda*ilit) of e@ercise o.tions1
c. Need Based component: It deals 8ith levels of health status and ho8 a .erson or

deliver) s)ste( .erceives the need for health services1


tilization of the healthcare services!

a. "ype: The >ind of services availa*le includes .h)sician+ hos.ital+ .har(ac)+ or

b. #ite: The location to receive the healthcare service is a factor to service usage1 c. Purpose: The .ur.ose for see>ing healthcare (a) *e .reventive or secondar) care in

nature 8ill deter(ine the t).e of service utili!ed1

d. "ime interval: it (easures the freAuenc)+ volu(e or continuit) of care1 4. Health outcomes!

a. Perceived health status b. Evaluated health c. Consumer satisfaction! This includes convenience+ Aualit)+ availa*ilit)+ financing+

and .rovider characteristics1 Describe the evidence on which the theory was based: The *ehavioral theor) 8as initiall) to stud) 8h) a fa(il) uses health services1 'ocusing on the fa(il) as a unit *elieving that (edical care an individual receives is a function of de(ogra.hic social and econo(ic varia*les of a fa(il) as a unit1 Ho8ever+ the (odel focus on the fa(il) changed to individual due to distinctl) variation of fa(il) (e(*ers1 Describe the application or the potential application of the theory: Scenario 1: An incident too> .lace at #an 3iego+ -alifornia on Canuar) &$+ &//61 #even )ears old *o) 8ith a .ainful sore throat and high fever 8as diagnosed 8ith (easles that could have *een .revented 8ith i((uni!ation1 nluc>il)+ the *o) trans(itted the disease to eleven other children in the sa(e neigh*orhood 8ho( did not receive (easles vaccination1 The Auestion in (ind is D7hat reasons .revented the .arents of these eleven children fro( utili!ation the availa*le i((uni!ations that could have .rotected the children fro( (easlesEF The ans8er received fro( (an) of the .arents is that vaccination causes autis(1 Autis( is a .erceived health conseAuence of childhood vaccinations 8hich the .arents of these children .erceived as a greater health ris> than the illness1 In this scenario+ the parents failure to utilize healthcare services was a consequence of perceived needs, perceived threats, diseases nowled!e, illnesses value, faith in treat"ent, and autono"ous health care choices#

BEHAVIORAL THEORY 5 Scenario $: %ulture, social resources &fa"ily econo"ic capital, social support, !roup nowled!e of diseases ' treat"ent(, and !eo!raphic location can affect the use of health services positively or ne!atively# 'or instance+ an individuals fa(ilies 8ith >no8ledge of an effective ho(e re(ed) usuall) .refer to atte(.t the treat(ent *efore using .rofessional healthcare services1 Most African,A(erican or foreign,*orn fa(ilies .rovides social resources+ s.ecificall) >no8ledge+ of 8hich a lone ill .erson (a) not have *een a8are1 Teen (others lo8 socio,econo(ic status+ education levels+ and lac> of self,efficac) hinder the( fro( accessing .renatal health services1 9iven the significantl) un(et need for healthcare+ nurses and other healthcare .ersonnel or organi!ation can hel. i(.rove the Aualit) of hu(an life through see>ing the reasons 8h) an individual and fa(ilies use or do not use these health care services1 This >no8ledge 8ill hel. nurses recogni!e ne8 consu(ers+ discover concerns of consu(ers+ and eventuall) increase consu(er satisfaction1 "urses a*ilit) to efficientl) address the needs and values of a .articular .o.ulation reAuire an understanding of their social,cultural structural d)na(ic lin>ed health care utili!ation deter(inants1 'utures .ro.ose research relating (ortalit) data to the geogra.hical area of ur*an co((unit) *) s.ecific illness and .rocedures 8ill assist healthcare .lanners and .olic)(a>ers achieve a fair allot(ent of funds1 There is need for e@.ansion of .redis.osing characteristics and ena*ling factors for an e@.licit .o.ulation1


References Andersen+ R1 M1 :%44$=1 Revisiting the *ehavioral (odel and access to (edical care: does it (atterE Journal of Health and Social Behavior+ 05 :%=+ %,%/1 of Health #ervices H #chool of 2u*lic Health niversit) of -alifornia+ Los Angeles1 :&//4=1 Biogra.hical infor(ation of Ronald Andersen1 Retrieve fro( 8e*site htt.:II8881.h1ucla1eduIhsI*ioJandersen1as.1