The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China

Oct 21, 2016BMC health services research

How personal, access, and health needs influence rural residents' use of health services in Guangxi, China

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Abstract

Chronic diseases are associated with 5.87 times higher odds of physician visits and 4.04 times higher odds of hospitalization among rural residents in China.

The presence of chronic diseases significantly increases the likelihood of utilizing health services.
Age, gender, marital status, family size, and education level are significant predictors of health service use.
Travel time to the nearest health facility influences the likelihood of physician visits.
Higher healthcare expenditures may hinder hospitalizations.

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BACKGROUND: Healthcare in China has significantly improved, meanwhile many socio-economic risk factors and health conditions factors affect accessibility and utilization of health services in rural areas. Inequity of health service in China needs to be estimated and reduced. Andersen behavioral model is useful to assess the association of health service utilization with predisposing, enabling, and need factors.

METHODS: A survey was conducted among 4634 residents of 897 households in 2012. Logistic regression analysis was performed to explore the association of predisposing (age, gender, marital status, ethnicity and family size), enabling (education level, travel time to the nearest health facility, medical expense per capita, and health insurance coverage), and need factors (chronic disease) with the utilization of health services (i.e. physician visit and hospitalization).

RESULTS: We observed a significant association between need factor (chronic diseases) and health service unitization, after adjusting for all predisposing and enabling factors (physician visits: odds ratio (OR) = 5.87, 95 % confidence interval (CI) = 4.71-7.32; hospitalization: OR = 4.04, 95 % CI = 2.90-5.61, respectively). In addition, age, gender, marital status, family size and education level were significant predictors of health service utilization. The travel time to the nearest health facility was associated with the utilization of physician visits, and expenditure on healthcare was a hindering factor of hospitalization.

CONCLUSIONS: The predisposing and enabling factors had a minor impact on health service utilization, while the need factor was a dominant predictor of health service utilization among rural residents in China.

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The impact of predisposing, enabling, and need factors in utilization of health services among rural residents in Guangxi, China

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