Megbowon Ebenezer Toyin, David Oladipo Olalekan, Makhalima Jabulile Lindiwe
School of Economic Science, North West University, Vanderbijlpark 1900, South Africa.
Healthcare (Basel). 2022 Oct 31;10(11):2186. doi: 10.3390/healthcare10112186.
(1) Background: An effective and efficient primary healthcare service is one of the reforms designed to achieve universal healthcare coverage. The success of the reform however depends on the ability to identify factors that could undermine through avoidable use, the effectiveness of various deployed scarce resources. The prevalence of unhealthy lifestyle risk factors that have been identified as a critical public health issue, which stimulate vulnerability and mortality through the development of non-communicable diseases, also have implications for government health spending through healthcare utilization. (2) Objective: This study aims to investigate the effect of behavioral risk factors on primary healthcare utilization in South Africa. (3) Methods: Using the NIDS wave 4 data set and a binary logistic estimation technique, the study is premised on a modified Anderson model of health service utilization. (4) Results: The binary logistic regression estimation results clearly show the intercepting effect of smoking in public primary healthcare utilization. Equally, the effect of these lifestyle behavior risk factors on public PHC is evident in urban communities. (5) Conclusion: This study suggests that there is a need to intensify awareness on the health effect of smoking; strengthen and broaden law that bans smoking; and introduce the screening of smoking patients for recurring counselling sessions and intervention at primary healthcare facilities in the country's urban communities.
(1) 背景：高效的基层医疗服务是实现全民医保覆盖的改革举措之一。然而，改革的成功取决于能否识别出那些可能因不必要的使用而削弱各种已部署的稀缺资源有效性的因素。已被认定为关键公共卫生问题的不健康生活方式风险因素，会通过引发非传染性疾病增加易感性和死亡率，还会通过医疗保健利用对政府卫生支出产生影响。(2) 目的：本研究旨在调查行为风险因素对南非基层医疗服务利用的影响。(3) 方法：利用全国收入动态研究第4轮数据集和二元逻辑估计技术，本研究基于健康服务利用的修正安德森模型。(4) 结果：二元逻辑回归估计结果清楚显示了吸烟对公立基层医疗服务利用的拦截效应。同样，这些生活方式行为风险因素对城市社区公立初级卫生保健的影响也很明显。(5) 结论：本研究表明，有必要加强对吸烟健康影响的认识；加强并扩大禁烟法律；并在该国城市社区的基层医疗设施中对吸烟患者进行筛查，以便进行定期咨询和干预。
