[A review of health-service use (1996-2006 )].
OBJECTIVE
Reviewing research papers published during 1996-2006 regarding ontological, methodological and epistemological proposals regarding the use of health services.


METHODS
Pub Med was screened for identifying the most relevant research carried out to date in the field. The key words <health services><accessibility> were used.


RESULTS
34 papers were included in the final analysis. 70 ,6 % referred to health service use in the USA ; 30 % analysed the socially disadvantaged population, focusing mainly on visits to the doctor (50 %). 31 papers (91,2 %) used a quantitative approach; the most studied variables in this approach regarded the individual (90,4%) the context (45,2 %) and the health system (41,9 %). The quantitative approaches used multiple regression for their statistical analysis; only 19 ,4 % of them incorporated more complex statistical models for analysing health service use. Qualitative studies analysed both discourse and content.


CONCLUSIONS
The findings reflected how the nature of health service use becomes reduced to using objective terms which necessarily tend to hide that such use is dealing with social integration. A wider perspective is needed for tackling health service use. Complementary (qualitative-quantitative) approaches provide different results helping to shape an integral vision of the same problem .
Ruiz-Rodríguez
Myriam
M
Departamento de Salud Pública, Universidad Industrial de Santander, Colombia. myriam@uis.edu.co
Valdez-Santiago
Rosario
R
D000293:Adolescent; D000328:Adult; D000349:Africa; D001208:Asia; D005060:Europe; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007843:Latin America; D015233:Models, Statistical; D012044:Regression Analysis; D012959:Socioeconomic Factors; D035862:Vulnerable Populations