A Description of Theoretical Models for Health Service Utilization: A Scoping Review of the Literature

Abstract

Theoretical models to explain health service utilization are numerous and there is no known literature that has synthesized existing models for health service utilization. Systematic searches were conducted in PubMed, MEDLINE, PsychINFO, Scopus, and CINAHL databases from 1960 through May 2021. Literature theorizing models/frameworks for health service utilization were included. Multiple investigators screened citations and full texts. Data extracted included: (1) citation information, (2) purpose of models, and (3) major constructs of models. The search retrieved 6639 citations. A total of 34 articles were eligible for this review. Theoretical models were categorized into 4 thematic domains based on the purpose of the model: (1) generalized health service utilization, (2) health service utilization with respect to specific sociodemographic determinants of health, (3) health service utilization specific to illness or health disciplines, and (4) preventive health services/screenings. There was an increase in models developed over time with a trend toward model development specific to sociodemographic determinants of health, illness, and/or health disciplines. This review cataloged theoretical models for health service utilization by thematic domain to enhance the identification and critical review of existing models. Findings support the notion that theoretical pluralism has been adopted in the field of health service utilization.