<p>The Influencing Factors of Health-Seeking Preference and Community Health Service Utilization Among Patients in Primary Care Reform in Xiamen, China</p>

Abstract Given the high Neo-natal mortality in the state of Uttar Pradesh, India, an emphasis has been given to community health workers (CHW). CHW provides behavior push to pregnant women for utilizing health services, through the strategies of household contact and messaging. However, the disparity in health outcomes and interaction of CHW is profoundly affected by socio-economic determinants; still, the evidence is limited. This study aims to explore socio-economic inequities in quantity and quality of contacts by the CHW and its differential effect on health service utilization. Multistage sampling design identified live births in the last 12 months across the 25 highest-risk districts of Uttar Pradesh(n = 3703). Regression models described the relation between household demographics and CHW contact & specific messaging and interactions of demographics and CHW contact & messaging in predicting health service utilization ( > = 4 antenatal care (ANC) visits, Institutional delivery and 100 iron folic acid (IFA) consumption). No differential likelihood in contact of CHW and specific messaging is found. Further, association of CHW contacts and specific messaging with health outcomes were significantly affected by socio-economic determinants.2 or more contacts along with specific messaging increased the odds of 4+ ANC to a higher degree among illiterate women compared to literate women(AOR:3.39, 95% CI:2.28-5.04 vs AOR:1.44, 95% CI:1.09-1.92). Similarly, the odds of facility delivery increased to a higher degree among lower wealth women compared to higher wealth women (AOR:3.41, 95% CI:2.47-4.71 vs. AOR:1.53, 95% CI: 1.09-2.15). Specific messaging, along with CHW contacts, have a higher magnitude of effects on the marginalized population. This study provides evidence for adjusting implementation strategies based on socio-economic determinants to achieve equitable health service utilization. However, further research on training of CHW on heterogeneous interaction is recommended Key messages There exists differential effects of quantity and quality of contact by community health workers on health service utilization across the different socio-economic strata. Implementation agencies in the LMIC can reduce health inequity by shifting from coverage-oriented target approach towards more prioritized and focused interaction across socio-economic groups.

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PHP61 INFLUENCE OF HEALTH-RELATED QUALITY OF LIFE ON HEALTH SERVICE UTILIZATION IN ADDITION TO SOCIO-DEMOGRAPHIC AND MORBIDITY VARIABLES AMONG PRIMARY CARE PATIENTS IN CHINA

Value in Health ◽

10.1016/s1098-3015(10)73510-5 ◽

2009 ◽

Vol 12 (3) ◽

pp. A89

Author(s):

T Chen

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Health Service ◽

Service Utilization ◽

Health Service Utilization ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Primary Care Patients

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Combined Management can Decrease Blood Pressure: A Health-seeking Behaviors Investigation among Hypertensive Patients in Urban Communities in China

10.21203/rs.3.rs-154409/v1 ◽

2021 ◽

Author(s):

Si Wang ◽

Kai Liu ◽

Xin Zhang ◽

Qingtao Meng ◽

Xinran Li ◽

...

Keyword(s):

Blood Pressure ◽

Health Service ◽

Community Health ◽

Urban Communities ◽

Community Health Service ◽

Service Center ◽

Health Seeking ◽

Hypertensive Patients ◽

Health Seeking Behaviors ◽

Medical Facilities

Abstract Background: Hypertensive patients can freely choose the informal medical facilities such as pharmacies, community health service centers, and cardiology clinics in secondary or tertiary hospitals, as the routine places for medical treatment in China at present. It is not clear the proportion, influencing factors and the effects on blood pressure (BP) of different health-seeking behaviors among hypertensive patients in urban communities. The aim of the study is to investigate the health-seeking behaviors and the effect on BP of different health-seeking behaviors among hypertensive patients in urban communities in China.Methods: A cross-sectional survey of hypertension was conducted in urban communities in Chengdu. 437 hypertensive patients seeking medical help regularly were sequentially enrolled to fill out the questionnaire on health-seeking behaviors.Results: The average age was 67.1±7.5 years. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 144.2±17.9 mmHg and 75.4±10.4 mmHg, respectively, and the control rate of BP was 41.0%. Among the hypertensive patients investigated, 5.2% of which chose the informal medical facilities, 62.8% chose the community health service center, 21.5% chose the cardiology clinics in secondary or tertiary hospitals, and 10.5% chose both community health service center and cardiology clinics as the usual places for medical treatment. There were statistical differences in education levels, proportions of home BP monitoring, establishing chronic disease archives in community, medication compliance and side effects of drugs among the four groups. The SBP was 150.9 ±19.8, 145.1±18.0, 143.8±17.5 and 136.3±15.1 mmHg (P=0.007) in the four groups respectively and it was significantly lower in the combined management group than in the other three groups. The control rate of BP was 23.8%, 39.4%, 43.0% and 54.8% (P=0.100), respectively. Compared with patients choosing the informal medical facilities, patients in the combined management group had significant higher BP control rate (OR = 3.679, P = 0.035).Conclusions: Combined management with both community health service center and higher-level hospitals can decrease BP.

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