Medical Faculty, Near East University, Nicosia,TRNC, Turkey.
Int J Health Policy Manag. 2020 Jun 1;9(6):240-249. doi: 10.15171/ijhpm.2019.106.
Understanding health-seeking behaviors and determining factors help governments to adequately allocate and manage existing health resources. The aim of the study was to examine the health-seeking behaviors of people in using public and private health facilities and to assess the factors that influence healthcare utilization in Northern Cyprus.
A cross-sectional study was conducted in 2 polyclinics among 507 people using a structured intervieweradministered questionnaire. Health-seeking behaviors were measured using four indicators including routine medical check-ups, preferences of healthcare facilities, admission while having health problems, and refusal of health services while ill. Descriptive statistics and multivariable logistic regression analyses were done to explore factors influencing the use of health services.
About 77.3% of the participants reported to have visited health centers while they had any health problems. More than half (51.7%) of them had a routine medical check-up during the previous year, while 12.2% of them had refused to seek healthcare when they felt ill during the last five years. Of all, 39.1% of them reported preferring private health services. Current smokers (adjusted odds ratio [AOR]=1.92, 95% CI: 1.17-3.14), having chronic diseases (AOR=2.05, 95% CI: 1.95-2.16), having poor perceptions on health (AOR=2.33; 95% CI: 1.563.48), and spending less on health during the last three months (AOR=2.08, 95% CI: 1.43- 3.01) had about twice the odds of having routine checkups. Higher education (AOR=1.87, 95% CI: 1.38-2.55) was shown to be a positive predictor for the health-seeking behaviors, whereas having self-care problems (AOR=0.18, 95% CI: 0.08-0.40) and having a moderate-income (AOR=0.68, 95% CI: 0.57-0.81) were inversely associated with seeking healthcare.
The utilization of public and private health sectors revealed evident disparities in the socio-economic characteristics of participants. The health-seeking behaviors were determined by need factors including chronic disease status and having poor health perception and also by enabling factors such as education, income, insurance status and ability to pay by oneself. These findings highlight the need for further nationwide studies and provide evidence for specific strategies to reduce the socioeconomic inequalities in the use of healthcare services.
了解卫生服务需求行为及其决定因素有助于政府合理分配和管理现有的卫生资源。本研究旨在探讨北塞浦路斯居民在使用公立和私立卫生设施方面的卫生服务需求行为，并评估影响医疗保健利用的因素。
在两家综合诊所中进行了一项横断面研究，共调查了 507 名使用结构式访谈问卷调查的参与者。使用四个指标衡量卫生服务需求行为，包括常规医疗检查、对卫生设施的偏好、有健康问题时住院以及患病时拒绝卫生服务。采用描述性统计和多变量逻辑回归分析来探讨影响卫生服务利用的因素。
约 77.3%的参与者表示在出现任何健康问题时会去卫生中心就诊。超过一半（51.7%）的人在过去一年中进行了常规医疗检查，而在过去五年中，有 12.2%的人在感到不适时拒绝寻求医疗保健。其中，有 39.1%的人表示更喜欢私立卫生服务。目前吸烟者（调整后的优势比[OR] = 1.92，95%可信区间[CI]：1.17-3.14）、患有慢性病（OR = 2.05，95%CI：1.95-2.16）、对健康的认知较差（OR = 2.33；95%CI：1.563.48）和过去三个月内健康支出较少（OR = 2.08，95%CI：1.43-3.01）的人进行常规检查的可能性是其他人的两倍。较高的教育水平（OR = 1.87，95%CI：1.38-2.55）是卫生服务需求行为的积极预测因素，而自我保健问题（OR = 0.18，95%CI：0.08-0.40）和中等收入（OR = 0.68，95%CI：0.57-0.81）与寻求医疗保健呈负相关。
公立和私立卫生部门的利用情况显示参与者的社会经济特征存在明显差异。卫生服务需求行为取决于包括慢性病状况和较差健康认知等需求因素，也取决于教育、收入、保险状况和自付能力等促成因素。这些发现突出了需要进行进一步的全国性研究，并为制定具体战略以减少医疗保健服务利用方面的社会经济不平等提供了证据。
