Yadav Rajaram, Zaman Kamran, Mishra Ayush, Reddy Mahendra M, Shankar Prem, Yadav Priyanka, Kumar Kaushik, Kant Rajni
Indian Council of Medical Research-Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), Gorakhpur 273013, India.
Department of Community Medicine, All India Institute of Medical Sciences (AIIMS Gorakhpur), Gorakhpur 273013, India.
Healthcare (Basel). 2022 Apr 19;10(5):757. doi: 10.3390/healthcare10050757.
The healthcare infrastructure of a country determines the health-seeking behaviour of the population. In developing countries such as India, there is a great disparity in the distribution of healthcare institutions across urban and rural areas with disadvantages for people living in rural areas.
Our objectives were to study the health-seeking behavior and factors associated with the use of formal healthcare among the Gorakhpur Health and Demographic Surveillance System (GHDSS) cohort of North India.
The study was conducted in 28 villages from two rural blocks in the Gorakhpur district of eastern Uttar Pradesh, North India. Structured questionnaires were used to collect the data with regard to demographics, health-seeking behaviour and healthcare utilization. An adjusted odds ratio with 95% confidence interval was used to report the factors associated with the utilization of healthcare.
Out of 120,306 individuals surveyed, 19,240 (16%) individuals reported having any health problem in the last 15 days. Of them, 90% sought healthcare for their health needs. The formal healthcare utilization was 79%. The use of public health facilities was very low (37%) with most of the people seeking treatment from private healthcare (63%). Females, people with a higher level of education (graduate and above), and those belonging to rich and middle tercile were more likely to use formal healthcare services. Among different ailments, respiratory problems, gastrointestinal problems, and musculoskeletal problems were associated with decreased use of formal healthcare.
About four in five individuals surveyed who had health problems sought treatments from formal healthcare with three in five preferring private institutions to public healthcare facilities due to a perceived higher level of treatment quality and nearby availability. There is an urgent need to re-establish community trust among public healthcare facilities with a focus on delivering on-site health care and enhancing the quality of services offered by public healthcare institutions.
一个国家的医疗保健基础设施决定了民众的就医行为。在印度等发展中国家，城乡地区医疗保健机构的分布存在巨大差异，农村地区居民处于不利地位。
我们的目的是研究印度北部戈勒克布尔健康与人口监测系统（GHDSS）队列中民众的就医行为以及与使用正规医疗保健相关的因素。
该研究在印度北部北方邦东部戈勒克布尔区两个农村街区的28个村庄进行。使用结构化问卷收集有关人口统计学、就医行为和医疗保健利用情况的数据。采用调整后的优势比及95%置信区间来报告与医疗保健利用相关的因素。
在接受调查的120306人中，有19240人（16%）报告在过去15天内有任何健康问题。其中，90%的人因健康需求寻求医疗保健。正规医疗保健的利用率为79%。公共卫生设施的使用率非常低（37%），大多数人寻求私立医疗保健机构的治疗（63%）。女性、教育程度较高（本科及以上）的人以及属于富裕和中等三分位数的人更有可能使用正规医疗保健服务。在不同疾病中，呼吸问题、胃肠道问题和肌肉骨骼问题与正规医疗保健利用率降低有关。
接受调查的有健康问题的人中，约五分之四的人寻求正规医疗保健治疗，五分之三的人因认为私立机构治疗质量更高且距离更近而更倾向于选择私立机构而非公共卫生设施。迫切需要重新建立公众对公共卫生设施的信任，重点是提供现场医疗服务并提高公共医疗机构提供的服务质量。
