Lords Education and Health Society, 159, Santosh Nagar, Jaipur, Rajasthan, 302019, India.
Lords Education and Health Society, Building No. 24 (3rd Floor), Okhla Phase-III, New Delhi, 110020, India.
BMC Health Serv Res. 2023 Apr 22;23(1):387. doi: 10.1186/s12913-022-08934-y.
Outpatient services are crucial for strengthening primary healthcare and reducing out-of-pocket spending, which has been one of the major causes of impoverishment. So it is also critical to comprehend the people's preferences in accessing primary healthcare facilities, as government primary healthcare facilities in India are underutilized. The current paper explores the factors that construct the individual's decision to seek outpatient care in primary healthcare facilities in India's largest state Rajasthan.
It was a cross-sectional survey conducted in 72 primary sample units of 24 primary health centers in 11 districts of Rajasthan, India, from November 2019 to January 2020. The study selected 368 households through purposive sampling. Out of 368 households, 460 people reported any illness and 326 reported outpatient visit to any health facility in the last 30 days from the date of the survey.
The focus was on analyzing the data in the context of public and private health facilities to understand the factors influencing people's choice to access outpatient services. The principal component analysis is used to understand the relationship between facility preparedness and OPD uptake. Also, multivariate logistic regression is applied to assess the significant predictors in using primary health facility services.
Except for the 29% of patients who received no care, the proportion of patients attended public health facilities was 35%, and the rest were utilizing private health facilities. Those who sought care at PHCs were mostly over 45 years age, non-literate, and from the lowest wealth quintile. Logistic regression suggests that people belong to upper wealth quintile (OR = 0.298; 95% 0.118-0.753) are less likely to visit PHCs for treatment. Also, increase in distance of PHC (OR = 0.203; 95% CI 0.076-0.539) reduces the likelihood of their visit outpatient care. People are 9.7 times (OR = 9.740; 95% CI 2.856-33.217) more likely to visit a PHCs that are better equipped in terms of human resources, equipment, and medicine.
The uptake of PHCs depends on several factors, which should be considered to ensure that all segments of society have equitable access to them. Through improved accessibility and quality of service, PHCs can be made more appealing to the larger population.
门诊服务对于加强基层医疗保健和降低自付支出至关重要，自付支出是贫困的主要原因之一。因此，了解人们对基层医疗保健设施的偏好也很关键，因为印度的政府基层医疗保健设施未得到充分利用。本文探讨了在印度最大邦拉贾斯坦邦，构建个人选择在基层医疗保健设施中接受门诊治疗的因素。
这是一项在印度拉贾斯坦邦 11 个地区的 24 个初级保健中心的 72 个初级样本单位中进行的横断面调查，时间为 2019 年 11 月至 2020 年 1 月。研究通过目的性抽样选择了 368 户家庭。在 368 户家庭中，有 460 人报告了任何疾病，有 326 人报告在调查之日起的 30 天内到任何卫生机构进行了门诊治疗。
本研究重点在于根据公共和私人卫生设施来分析数据，以了解影响人们选择门诊服务的因素。主成分分析用于了解设施准备情况与门诊就诊之间的关系。此外，还应用多元逻辑回归评估使用基层卫生机构服务的显著预测因素。
除了 29%的未接受治疗的患者外，在接受治疗的患者中，选择公共卫生设施的比例为 35%，其余的则选择私人卫生设施。在那些到 PHC 就诊的人中，大多数年龄在 45 岁以上，没有文化，来自最低的财富五分位数。逻辑回归表明，属于上一个财富五分位数的人（OR=0.298；95%CI 0.118-0.753）不太可能到 PHC 就诊。此外，随着 PHC 距离的增加（OR=0.203；95%CI 0.076-0.539），他们就诊的可能性也会降低。在人力资源、设备和药品方面配备更好的 PHC，人们前往就诊的可能性增加 9.7 倍（OR=9.740；95%CI 2.856-33.217）。
基层医疗保健的就诊率取决于多个因素，应考虑这些因素以确保社会各阶层都能公平地获得基层医疗保健服务。通过提高基层医疗保健的可及性和服务质量，可以吸引更多的人使用基层医疗保健。
