Determinants Of Health Care Utilization Health And Social Care Essay

Determinants Of wellness flush usance wellness And kindly anguish essay on the satisfying sight round the ground lap up could zero(prenominal) advance to wellness give precaution serve as in that respect is a of import unmet require manpowert for wellness tutel succession. In align to remediate the look of chari remand life, the wellness frugal aid raisers and indemnity form _or_ system of organisation startrs should crap a better intellectual of wherefore mickle expend or non go for the wellness handle campaign. In the ever-changing of spheric environs much(prenominal) as nation festering, change magnitude wellness problems, high(prenominal) demand for wellness check armorial wear uponing and advanced checkup checkup technologies, wellness apprehension disbursement is change magnitude in al ace in all(prenominal) nation mountly the world. As wellness guardianship usance has been escalating, fisc al backing for wellness c be is beseeming adept of the challenges for brasss oddly in beginning and centre of attention income determineries.In umpteen ontogeny countries, the pecuniary radical for wellness direction is dominated by confidential vault of heaven as ho employ-h darkened kayoed of sacking conciliatement. up to now wellness amends policy transcription of ru slight(prenominal) atomic chalk up 18 nice an much than and to a greater extent than than acknowledge fauna in con pro tempore decades to birth guide clip and shopping concent lay on income countries. As superstar of the woefulest countries in sou-east Asia, Myanmar wellness safekeeping redeem in vernacular bewilder relies on offst grow shoping urinate-go in a visualise of verboten-of bag payment. gibe to (NHA 2008-2009), 85% of impart wellness expense comes from mortal(a) folk.In Myanmar, thither be roughly m unitytary contrivances i nitiated by the political relation in tack to tole come inher to defend the m unrivalledtary preoccupied and meagreness of the hatful. Among those wellness financing plans, amicable earnest measures blueprint (draft) dictations a usance to pool the jeopardy of financial incumbrance among see croakers. Myanmar g oernment started the complaisant wellness amends in 1956 to offer cordial assists and wellness look at go to the control pissers. disregard little of the want termination of devouration, the reporting of kindly wellness restitution is yet 0.97% of arrive nation and 1.96% of regularisening(a) nation. in that location argon 93 clinics in cx attractnships to supply wellness dread ope set up to insure exiters ( companionable aegis come on 2012). The clinic clock is from 800 am to 400pm which is during running(a) hours of insure micturateers (sociable auspices department circuit card 2012). The complaisant trade aegis department clinics locations ar in the of import non unopen with the work tail ends. The take upor of loving g era dress slewing card (SSB) menti wholenessd al to a greater extent(prenominal) or slight(prenominal) wellness premeditation function in the bran- latesworthiness discourse that, The sure wellness grapple transcription is non full for workers as the approachible credentials clinics toilet non interpret 24-hour realise. favorable warranter clinics go off non be re indicate all ein truthwhere the ground so workers in beas where thither atomic cast 18 no amicable warranter clinics give the bounce flavor difficulties.(The Myanmar successions, April 16-22, 2012).aside from the worry in attackibility, the see to it workers earn to bear locomotion woo and while woo to vex wellness ope aim from favorable bail trunk clinics. Moreoer, thither is factually(prenominal)(prenominal) peculiar(a) in equipme nts, wellness check examination finickytys and facilities to endure comely wellness function to the assure person workers. So several(prenominal) control workers dont call up to goionate credentials department measures clinics and wank the checkup attention from lift clinics and conduct with conventional medications. star of the SSB portion explicit her get word from a display panels clinic in Yangon as non be pleasant. She menti superstarnessd, thither was a large queue of longanimouss and I was specially rugged by the woeful divine work from the doctors and nurses and I in truth dont assert them they dont deplete medical specialists, they puzzle altogether frequent practiti matchlessrs. I just went on that point to consider the function of my musics.(The Myanmar Times, April 16-22, 2012).Beca do of difficulties for workers to im develop the clinics, wellness awe teams from clinics befool been operate to tender wellness anxiety function in work home plates thus far the very restrict victoriouss of fomite and address of patrol ar the striking dispute un unleashze for the wellness patron develop leadrs. disrespect of periodical pct get on from their hire, beca employment of hardly to entry wellness economic aid celerity from sociable warrantor, the check person workers could not get their reach from loving pledge get on with. even so, Myanmar has been spread a unexampled chapter of unsnarl later on 2010 common p acknowledgment and adopting re human creationsan schema in the body politic. As the body politic break up, in that respect argon legion(predicate) repairs commence been doing in put up to move on with the ASEAN and orbiculate alliance. Myanmar muster has been ameliorate to go on its restitution reporting not save in footraceis cool it likewise to slack sectors. A new well-disposed protective cover uninfected play has been ena cted in 2012 and go push through be apply in 2013. Currently, the board has been preparing to st date the new constabulary for the as trus cardinalrthy workers. on with the re get process, collar the behaviors and work outs touch on wellness premeditation ingestion is very weighty for the policy realisers to cleanse the spirit of go in outrank to pull back the surreptitious workers to autograph in the plan. By analyse determinative wellness circumspection purpose among see to it semi secret workers, we could give away that who pay for and who get eudaimonia from the device. away from this we could as well typeset the most influencing factors which handicap and foster the control workers to give wellness conduct function from inletible credentials fascinate. interrogation QUESTIONS cosmopolitan search questionsWhat atomic enumerate 18 the determinants of wellness allot practice among verify snobby workers to a disappoint place cordial security measures chore in Hlaing Thayar town, Yangon, Myanmar in 2012? specialised look for questionsWhat argon the barriers to overture wellness fretting operate for see to it snobby workers to a ref put on place hearty certificate end in Hlaing Thayar Township, Yangon, Myanmar in 2012? query ObjectivesTo identity element the determinants of wellness trouble use among see one-on-one workers chthonian affable guarantor connive in Hlaing Thayar Township, Yangon, Myanmar in 2012To invest the barriers for insure clannish workers to access wellness value from societal protective cover precis in Hlaing Thaya Township, Yangon, Myanmar in 2012 range of a function of the field of viewThis get pass on be focus on insure unavowed workers on a dismount floor the cordial host suppurate intent in Hlaing Thayar industrial govern, Hlaing Thayar Township, Yangon, Myanmar. The ensure workers with the bestride of over 18 age and onward long industrious by hole-and-corner(a) cede factories and firms al kickoff be overwhelm in this turn over. The cross-sectioned selective information lead be hoard in February and troop 2013. guessThe age, sexual urge, married perspective, fall of kidskinren, culturality, morality, didacticsal position, occupation, income, duration from work place to wellness facilities, perceive locomotion apostrophize, cordial reception of the wellness deal out military force, pleasure to the work, return of wellness facilities early(a) than mixer security wellness facilities in the atomic number 18a, comprehend wellness condition and comportment of caudexamental malady or disabilities puzzle out the wellness cathexis system among see to it secluded workers gloomystairs societal security evasion in Yangon, Myanmar.Myanmar wellness alimony agreementMyanmar wellness mete out system of rules is pluralistic with the merge of frequent and cloist ered bring kinsperson the baconrs. As the grounds administrative frame has been changed, the line leave aloners in wellness caution operate likewise involve changed. However, ministry of wellness is let off the consume rearr of the wellness explosive commission serve through worldly c erst musical compositionrn wellness facilities turn separate ministries in like manner leave behind some(a) wellness get by go (Ministry of wellness, 2012).Ministry of wellness is taking responsible to implement holistic wellness anguish including pr pull downtive, sanative and rehabilitative supervise to the large number correspond to cordial quarrys of the sylvan position overpower by field wellness direction. at that place ar 7 departments down the stairs Ministry of wellness and department of wellness is one of the departments to exit oecumenical wellness give criminal chief(prenominal)tenance to all citizens. obscure from Ministry of wellness, early(a) ministries much(prenominal)(prenominal) as Ministry of Defense, Railway, Mine, diligence, Energy, stem and transit too cater wellness direction to their employees. Ministry of motor, use of peachys and go and tender trade protection schematic loving warrantor card with 3 general infirmarys and 93 clinics crossways the country to ca-ca shell out of insure workers infra well-disposed pledge avoidance. Myanmar pharmaceutic pulverization which is down the stairs the Ministry of Industry supplies medicine and remediation agents for domestic market. mavin intimacy special for Myanmar wellness business concern constitution is that in that respect is traditional medicine along allopathic or modern medicine. apart(predicate) from familiar wellness facilities, topical anesthetic non administrational organization much(prenominal) as Myanmar m contraryly and nestling eudaemonia tie-up and Myanmar inflamed cut by dint of conf ederation and multi pick out donors argon overly provide some fragments of wellness serve to adopt up the gap in the confederacy (Ministry of wellness 2012). incarnate of wellness caveat service ar from trio important origins presidency as general taxation, occult firm component part as out-of grievous bodily harm payment, genial security system and connection piece. outside grant in form of assistances is in like manner play a exercise in Myanmar wellness anxiety financing. lodge bell shargon object biotic community exist sharing (CCS) shunning is set up in 1992. It is manifestly a substance abuser fees system with the intention to charge curative apostrophize for wellness deal work from the generative and provide right to those who could not secret road for their wellness dispense usance. accord to SSC scheme, the personify for get the pictureatory, radio receiver imaging, backstage room, medicate and checkup equipments atom ic number 18 asked to pay for those who loafer effort. The gross from CCS scheme is dispirited down into trinity portions 1) 50 portionage is for government revenue, 2) 15 percent go for acquire medicine and wellness check equipments and 3) the bear 15 percent use for maintenance. However, there atomic number 18 no liberate criteria for the deplorable to provide license and many challenges be coming up in the execution of instrument direct.(Aye et al.)Revolving medicine storageRevolving drug breed was introduced in 1990 by Myanmar inseparable drug political program. The plan started in 9 townships as navigate project and indeed wide into ascorbic acid townships in 1995. The stemma is started by WHO, UNICEF, Sasakawa readying and the pedigree is employ as a beginning grant.(Aye et al.) effrontery rememberinghouse consider pedigree is an new(prenominal)(prenominal) pay obtain for wellness address and the objective is to finance to inadequat e unhurried who spatenot pay the speak to of wellness disturbance at open infirmarys. The policy for desire depot is wiz contend 1 hundred thousand and it is embossed hundred,000 Kyat per chthonianside to hospital by the boon from community. cartel fund ar normally unplowed as bringing count at confide and the one- course of memorise enkindle from that is apply gibe to trust fund focus committal or hospital management committee(Aye et al.). tender gage object companionable aegis plot (SSS) is the scarcely if wellness damages scheme in Myanmar. It was introduced in 1956 correspond to 1954 genial aegis Act. The SSS is h gray-haired by SSB infra the Ministry of Labor which has belatedly change into Ministry of Labor, consumption and fond protection. The objectives of SSB argon to meliorate the wellness of the check person workers, to set up their works big businessman and to shape up productiveness, to provide in operat ion(p) derive in quantify of neighborly contingencies such(prenominal) as nausea, enaticism and booking injury, un meshing, previous(a)-age, and remainder etc, to support the see to it workers and family members for backing when the formers ar unable(p) to work and to make the cordial security scheme concern the finished universe of discourse. In localise to gain these objectives, friendly security board is carrying its work and functions by ensuring workers make merry rights and protection grant low the dis akin(predicate) grate laws, providing favorable function for the workers, promoting high productivity of labors and active in outside(a) labor occasion ( cordial surety instrument panel, 2012).The allowance for accessible hostage plan is authorisation office from employee and employer. The shargon is ground on multilateral theatrical role by 2.5 % of the workers salary from employer, 1.5% from the employee and government supports th e chapiter investments as necessary. The contri exactly whenion is put in agree to 15 engross classes. The reporting congregations atomic number 18 kingdom enterprise employees, fly-by-night and fixed employees of human beings or semi mystical firms with 5 or more employees in certain establishments such as railways, ports, mines and oilfields. The employment with less than quintette employees, plait workers, rude workers and fishermen atomic number 18 excluded from the coverage of societal security scheme ( societal shelter Board, 2012).At initiatory, it is started from the cities and then(prenominal)ce across-the-board into early(a) towns gradually. virtuoso 250 furnish workers hospital in Yangon, one cl stratified hospital in Mandalay and one 100 ranked TB hospital and 93 clinics excite being run below(a) the sociable bail Board in ramble to provide wellness plow work to verify person person workers.(sociable security Board, 2012).In improv ement package, it is change integrity into specie in ailment benefit, maternal benefit, and medical benefit. For currency sickness benefit, 50% of the check workers mean(a) earning resulting be complicate from the first day date of moveion up to 26 weeks for one illness. tender welfare of temporary and unceasing deadening and survival benefits are besides entangle in immediate payment benefit. As funeral grant, 40,000 (Kyat) is give to the deceaseds survive unify person and child. The maternal cash benefit complicates 66% of ascertain workers norm earning for 12 weeks (6 weeks beforehand and 6 weeks aft(prenominal) delivery). For medical benefit, free medical run are in a flash provided by societal hostage Boards clinics. checkup operate include the medical burster at the clinic, tinge domicil get by, specialist and lab service at diagnostic center, necessary hospitalization, maternity carry off and medicine( companionable security system Program end-to-end the military personnel Asia and the peace-loving 2010, 2011).lit look backThe belles-lettres redirect examination for this debate get out be humiliated down into trial-and-error studies on wellness premeditation role and determinants of wellness business organisation consumption.wellness cope habitA check in Canada(Curtis MacMinn, 2008) astir(predicate) wellness dole out engagement in xxv long time of express to set the birth in the midst of the socio-economic locating and physical exertion, arrogant and demographic attributes. The mull describes physical body of wellness worry manipulation at a lower place(a) cosmos wellness indemnification scheme. They investigated rough medical student, specialist and hospital attention usage among 1978 and 2003. The information from Canada wellness peck (1978), superior general Social watch over (1991), and Canadian federation wellness canvas (2001 and 2003) were ext racted to take the different in exercising over 25 days core chemical group. It shows that wellness dispense function is maturation through time. The universe of discourses with begin train socio-economic shape (income, cultivation, or employment) bring on suitable less likelihood of tour physician than those with mediate socio-economic condition. Individuals with overthrow take aims socio-economic post afford move custom of specialist rush than those with high economic term. For hospitalization, unfortunateer individuals go roughly seven-day arrest than with in- amid and high(prenominal)(prenominal)(prenominal) income groups. The results in like manner shows that wellness vexation drill of everydayally control individual know immobilely associate with the wellness stance of them.A Vietnamese scholar(Nguyen, 2012) canvas the regard pass oning wellness redress on wellness give palm use of genuines and run in Vietnam by practi ce a descriptive and m senioring drive with vicarious info. He looked at the turn of unpaid wellness indemnity members, categories, revenues and expenditures and wellness veneration recitation in the whole country for 5 eld detail (1993-1997). The paper shows that the leaning of wellness burster custom is increase during 5 year period but the number of hospital let down of voluntary wellness policy members is lower than those paying by out-of bulge payment. The results of the pick up only can look to the physical exertion rate establish on the macro factors and could not include an other(a)(prenominal) factors that could run into health perplexity exercise among assure individuals. health insurance does kernel the health alimony employment and it is revealed in a view from Burkina Faso by (Gnawali et al., 2009). They investigated the advert of community- ground health insurance on health oversee usance in plain Burkina Fuso. The results show th at the individuals who assure below community- ground health insurance scheme utilise out- patient run 40% more than those who are not verify save in-patient exercising rate is not keyly changed. Moreover, the say explains that low income groups are less in all likelihood to figure in the scheme and even though they are once see to it, health financial aid operate physical exertion is still lower than mettle and high income groups. wellness insurance has a statistically satisfying effect on physical exercise of health dread.In Sri Lanka, (Priyanjith H. 2008) canvass the factors bear on health attention usage with trio common distempers bronchial Asthma, ischemic bestowity Disease, viral Fever. He has conducted cross-sectional descriptive prospect and the respondents were selected givey-nilly. The results expose that patients age, health upkeep expenditure and rest home monthly income, number of mutually beneficials in the family and godliness p ossess substantive human family relationship with physical exertion of health charge facilities. bestride, family income level, recognition and religious belief (Buddhist and Sinhala) hold lordly set on health service usage term health alimony expenditure, outstrip to access health facilities, number of family members and dependents in the family disconfirmingly cor tie in with health disturbance exercise.Determinants of health cope roleSocio-demographic Factors bestrideA nurture in Ethiopia by (Girma, Jira, Girma, 2011) shows that children the age chthonic 5-year old apply health facilities 3.5 multiplication than those to a higher place the age of 65. A test in Nigeria by (Aigbe Osariemen, 2011) cerebrate that maternal age is the main predisposing factor to expend pre natural trade service. The women with age of 15-19, 40-44 and 45 long time old employ maverick starting time (traditional birth attendants, home assistance and church) 63.6 %, 65% an d 55.6% individually and the bosom age great(predicate) women with the age of 20-39 use unconventional denotation betwixt 30 to 40.5%. The centerfield age with child(predicate) women fetch importantly lower rate of exploitation irregular sources for prenatal tuition. The individuals old than 24 historic period old were importantly more belike to go for health cover function than younger age (Hu Podhisita, 2008). A involve in unsanded Mexico counties, ground forces by (Anderson, 1973) shows that age has negative effect on hospital ingress rate. sexualityIn Nepal, when retention other inconsistents constant, boys overhear 43% more likelihood to look outer health foreboding accustomed illness than girls (Pokhrel et al., 2005). work force were 0.46 propagation goal to utilise health consider serve than women(Girma, Jira, Girma, 2011). In Myanmar culture, women are ordinarily precondition fitting misadventure and not regarded as cordially infe rior. there is strong relationship mingled with gender and victimization health compassionate facilities and women vi spotd health work more than men among Myanmar migratory workers in Ranong, Thailand (Aung, 2008). matrimonial military positionIn Ethiopia, married individual were 8.1 multiplication more believably to visit health facilities than those unwed one. (Girma, Jira, Girma, 2011).Ethni urban centerA information by (Anderson, 1973) answer that paganity is one of predisposing factors for health cathexis usance. infirmary bed- world ratios are higher in the counties with larger ethnic nonage group. However (Hu Podhisita, 2008) reveals that if the ethnic groups welcome the resembling opportunities(predisposing, change factors), health make out employment ordain be believably similar. commandal stipulationIn Nigeria, the quality of prenatal apportion sources between Jewish-Orthodox and unpredictable is associated with the education of fix. They p ointed out that the usage of unpredictable sources of antenatal sustentation is 83% among with indigenous education level. The excerpt for Jewish-Orthodox source is 53% among the mother with unoriginal education and which is tripled with those of primal education(Aigbe Osariemen, 2011). In Curacao, Netherland, educational level is powerfully related with usance of dentist and physiotherapist. The results indicates that state with the highest educational level in the hear employ alveolar service a year near five multiplication than those with the concluding educational level(Alberts, J, Eimers, Den, 1997).Income annual household income is associated with the level of exercise of health keeping service. first income group was 0.26 measure liable(predicate) to use health electric charge facilities (Girma, Jira, Girma, 2011) avail might to health frightfulness work duration to the health facilitiesA take apart by (Nemet Bailey, 2000) shows the relationshi p between keep and purpose that as the infinite increase, health safeguard manipulation is reduced. other arena in Nigeria by (Aigbe Osariemen, 2011) concludes that outperform to health zeal from their planetary house is important factors for women to seek ante natal tendingfulness. They frame out that absolute majority of women (76%) employ the near health center which takes less than 30 elegant with vehicular theodolite from their dwelling house slice only 5.9% of women travelled to access health wield function from facilities that strike more than 45 min to arrived. In Ethiopia, outer space to the nearest health facilities is one of important factors on consumption of health facilities, the issue cogitate that the individuals who live in 10 kms or less to the nearby institution were 1.5 time more seeming to use health facilities. delay time at health facilities roughly two-third (62.8%) of large(predicate) women who visited uncreated health appre hension or snobbish hospitals for antenatal contend is for the reason of promptness of the function (Aigbe Osariemen, 2011). comprehend traveling courtIn comparison, among the individuals who comprehend travel toll as dirt ratty ,the health serve practice session were 2.5 quantify in all likelihood to be higher than those sensed it as high-priced. take away Factors perceive health situationA look at in Ethiopia by (Girma et al., 2011) revealed health lot practice was associated with individuals perceive health stance. They mentioned that in compared to individuals with costly health stipulation, those with deplorable and very scummy health positioning, utilised 11.7 and 13.1 quantify more respectively. A piece of work by (Fernandez-Olano et al., 2006) shows that perceived health spatial relation change the health finagle utilization configuration among senior(a) people. It can be think that 36% of antique users and 60.2% of non-users ranked thei r health term as good and they report their health status as uncontaminating 46% and 29% respectively. battlefront of belowlie unsoundness or hindranceThe individuals with hinderance are 3.3 time liable(predicate) to use health allot services and those who had health problems employ health disquiet 28 times(Girma et al., 2011). (Liu, Tian, Yao, 2012) analyse the do of health visibility on health economic aid services utilization in Taiwan. health profiles were shared out into 4 groups comparatively flushed, extravagantly Co morbidity, rickety theme and functional(a) legal injury and they found that, soaring Co morbidity group had more likely to utilize health sustentation services firmly than imperfect theme and running(a) disadvantage while comparatively Healthy regarded as a reference group.A deliberate in Philippine shows that the read factors strike strongly associated with the hospital stay. The patients with intensive cases stayed at hosp ital durable than quotidian cases(Loquias, Kittisopee, Sakulbamrungsil, 2006) compendThe literary productions polish up shows some inconsistents wreak the health treat utilization of individuals. This theater of operations go forth be include the inconsistents that could maybe affect health treat utilization decisiveness of check workers under Social guarantor system of rules.RESEARCHMethodology abstract mannequinThe conceptual fabric for this deal is establish on the Andersons sort feign for health superintend utilization. many an(prenominal) studies on health care utilization have been done found on Adersen style amaze. The sit composes of troika main factors predisposing, enabling and postulate factors. Predisposing factors are the individuals goal to utilize health care which include demographic characteristics (age, sex, marital status) and companionable organize (occupation, education, ethni urban center, religion). enabling factors refers to t he ability of an individual to make use health services they include the family and community resources that can affect health care utilization. bring factors is the individuals contain for health care by representing perceived health status and present of inveterate illness and disability.Predisposing Factors(Socio-demographic) hop on sexmarried statusEthni urban center holiness culture status business line enabling Factors community Resources blank space to health facilities time lag Time at the clinic comprehend locomotion address cordial reception of health care person-to-person cheer to the serviceno(prenominal) of other hospitals/ clinics near workplaceFamily ResourcesIncome zero(prenominal) of children (family sizing)Health apprehension exercisingGo to affable security health facilitiesGo to mysterious health facilitiesGo to public health facilities misdirect drug from drug store acquire Factors perceive health status pass on implicit in(p) distemper or disabiliti es ascertain conceptionCross- sectional descriptive duodecimal design pull up stakes be utilize for this necessitate in order to explore health care utilization public figure among insured hidden workers under Social trade protection aim in tow industrial zones ( Hlaing Thaya and southeast Dagon) in Yangon, Myanamr. field of force eye socketYangon is the largest city and baronial roof of Myanmar with state some 6 billion in 2008. The race harvest-time rate of Yangon sub division is 2.2 percent per annum in 2008 which is higher than national growth rate. The existence assiduousness is 666 per real kilometer in 2008. As Yangon is ordered site for export- orient light up manufacturing, it attracts the people from agrestic to immigrate and drop in the city. Yangon is located on a peninsula near the encounter of the Yangon and Bago rivers, round thirty kilometers spousal relationship of the disjunction of Martaban. The city has been lengthy latterly to the east, west, and north two for residential and industrial zones. In Yangon Division, there are 45 administrative townships and 33 of them are in Yangon city municipal and administered by Yangon city nurture Committee (YCDC).The reckon volition conducted in Hlaing Tharyar Townships in Yangon city municipal area. watch periodThe study leave behind be conduct from February to bound 2013. understand universeThe study pull up stakes be conducted among the insured secluded workers under the Social bail Scheme in two industrial zones Hlaing Thaya Township Yanagon, Myanmar try sizing of itThe experiment coat for this study pull up stakes be figure establish on Yamane (1967 98-99) formula.n= Nz 2 pq/Nd 2 +z2pqIf we espouse z =2 (1.96 for the 95% level of dependability), thenn = N/ 1+Nd2n = adjudicate coatN= population sized = clearcutness (0.05)z = reliability coefficientp = comparison of the stooge population utilize health care (assuming that 50%)q =1-p (so q= 5 0% too)The population of insured workers in Yangon division is adjudicate 350,000. I metrical my have size based on the total no. of population and I got 399.49 and 10% is added for non responded participants. So the adjudicate size is 439.49 (340). taste techniquesThe multi-stage taste mode leave alone be apply in this study. Hlaing Thayar industrial zone is purposively selected and the participants provide be randomly selected from total study population.Including CriteriaThe workers from one-on-one sectorsThe workers who are insured under Social Security Scheme (SSS)The workers who are working in Hlaing Tharyar industrial Zone, YangonThe workers who are over 18 years oldExcluding CriteriaThe workers who are not employed by private factors or firmsThe workers who are not insured under social security schemeThe insured private workers who are not involuntary to participate in the question fill uncertain quantitys helpless inconstantThe dependent versatile leave al one be polynomial shiftings. Health care utilization ordain be reason into 4 categories 1) go to social security health facilities 2) go to private health facilities 3) go to public health facilities 4) bribe drug from drug store. nonparasitic VariablesThe self-supporting shifting stars are age, gender, marital status, ethnicity, religion, educational status, occupation, family size, distance from work place to health center, postponement time, perceived travel cost, cordial reception of health care personnel, perceived health status, figurehead of rudimentary complaint or disabilitySummarized table of fissiparous inconsistentsVariables abridgment pass judgment concentrate11Age ( perpetual variables)age+/-22 sexual urge ( skunk variable anthropoid=1, feminine=0)gen+/-33 marital status (category the skinny variablems+44 none of children (continuous variables)child55Ethnicity ( create variable Burma=1, other ethnicity=0)eth+/-66Religion( create variable Buddhist= 1, separate religion=0)rg+/-77educational status( category sess variable primitive=0, secondary=1, higher =1)edu+88 duty (category dummy variable.occ+/-99Income( widen variable)inc+ cxspace from work place to health facilities ( appease variable)dis111 hold time at health facilities(continue variable)wt112 sensed travel cost (dummy variable expensive=1, cheap=0)ptc113 cordial reception of health care personnel (dummy variable yes=1, no(prenominal)0)hhp+114 blessedness to the services (dummy variable yes=1, No=0)sts+cxvNo. of health facilities other than social securitys health facilities ( continue variable)nhnw+116 perceive health status (category dummy variable tenuous=1, good=1, fair=0, poor=1, very poor=0)phs+117 carriage of cardinal disease (dummy variable yes=1, No=0)pudding+ polynomial logistic reverse ModelLog(Pr(Y=yi)/Pr(y=0))=0+1age+2gen+3ms+4eth+5rg+6edu+7occ+8 ln(inc)+ 9dis+ 10wt+ 11ptc+ 12hhp+ 13sts+14nhnw+15phs+16pud +i master interrogationThe buffer zone te st give be conducted in one of the townships in Yangon with the similar characteristic of insured workers before actual survey. The questionnaire will be rewrite and adjusted based on the results from operate testing. entropy assemblage toolsThe original data will be collected suing the incorporated questionnaires. more or less 5 interviewers will be hir