Agrawal Tanisha, Bhattacharya Shubhro, Lahariya Chandrakant
Department of International Business Economics and Finance, Gokhale Institute of Politics and Economics, Pune, Maharashtra, India.
Department of Health Systems, World Health Organization India, New Delhi, India.
Indian J Community Med. 2020 Jan-Mar;45(1):77-82. doi: 10.4103/ijcm.IJCM_254_19.
or Community Clinics of Delhi, India, have made primary care accessible, equitable, and affordable for women, elderly, and children in the underserved areas.
To understand the population subgroups which use these clinics and to analyze why people use these facilities and the determinants of the return visits for health seeking.
This was a community-based cross-sectional study, with primary data collection from 25 localities across Delhi. A pretested semi-structured interview schedule was used for data collection. Two regression models were used for data analysis: a linear probability model to understand the factors contributing to the use of these clinics and a probit regression model to understand the determinants of return visits to these facilities.
Four hundred ninety-three ever-married women residing in study settings were included. The age of beneficiaries, marital status, distance from the clinics, and awareness about the services were found to be positively associated with the use of Clinics. The proximity to households, waiting time at clinics, interaction time with the doctor, perceived performance of doctor, and effectiveness of treatment influenced the decision on a return visit for care seeking.
Improved information on service provision, proximity to the facility, assured provision of doctors and laboratory services, and increased patient-doctor interaction time have the potential to increase the use and return visits to these Community or Clinics. The lessons from this study can be used to design government primary health-care facilities in urban settings, for increased use by the target populations.
印度德里的社区诊所已使弱势群体中的妇女、老年人和儿童能够获得初级医疗保健服务，且服务具有公平性和可负担性。
了解使用这些诊所的人群亚组，并分析人们使用这些设施的原因以及复诊寻求医疗服务的决定因素。
这是一项基于社区的横断面研究，从德里的25个地区收集原始数据。采用经过预测试的半结构化访谈提纲进行数据收集。使用两个回归模型进行数据分析：一个线性概率模型用于了解使用这些诊所的影响因素，一个概率单位回归模型用于了解复诊到这些设施的决定因素。
纳入了居住在研究区域的493名已婚妇女。发现受益人的年龄、婚姻状况、离诊所的距离以及对服务的知晓程度与使用社区诊所呈正相关。离家庭的距离、在诊所的等待时间、与医生的交流时间、对医生表现的感知以及治疗效果影响了复诊寻求医疗服务的决定。
改善服务提供信息、靠近设施、确保提供医生和实验室服务以及增加医患交流时间有可能增加对这些社区诊所的使用和复诊。本研究的经验教训可用于设计城市地区的政府初级医疗保健设施，以增加目标人群的使用。
