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Andersen healthcare utilization model
The Andersen Behavioral Model of Health Services Use is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need. Predisposing factors can be characteristics such as race, age, and health beliefs. For instance, an individual who believes health services are an effective treatment for an ailment is more likely to seek care. Examples of enabling factors could be family support, access to health insurance, one's community etc. Need represents both perceived and actual need for health care services. The original model was developed by Ronald M. Andersen, a health services professor at UCLA, in 1968. The original model was expanded through numerous iterations and its most recent form models past the use of services to end at health outcomes and includes feedback loops.
== Access and Mutability==
A major motivation for the development of the model was to offer measures of access. Andersen discusses four concepts within access that can be viewed through the conceptual framework. Potential access is the presence of enabling resources, allowing the individual to seek care if needed. Realized access is the actual use of care, shown as the outcome of interest in the earlier models. The Andersen framework also makes a distinction between equitable and inequitable access. Equitable access is driven by demographic characteristics and need whereas inequitable access is a result of social structure, health beliefs, and enabling resources.
Andersen also introduces the concept of mutability of his factors. The idea here being that if a concept has a high degree of mutability (can be easily changed) perhaps policy would be justified in using its resources to do rather than a factor with low mutability. Characteristics that fall under demographics are quite difficult to change, however, enabling resources is assigned a high degree of mutability as the individual, community, or national policy can take steps to alter the level of enabling resources for an individual. For example, if the government decides to expand the Medicaid program an individual may experience an increase in enabling resources, which in turn may beget an increase in health services usage. The RAND Health Insurance Experiment (HIE) changed a highly mutable factor, out-of-pocket costs, which greatly changed individual rates of health services usage.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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