Health-care utilization and associated factors in Gauteng province, South Africa
Health-care utilization and associated factors in Gauteng province, South Africa
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DOI：
10.1080/16549716.2017.1305765
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发表时间：
2017-06-02
影响因子：
2.6
通讯作者：
Levin, Jonathan
中科院分区：
文献类型：
--
作者：
Abaerei, Admas Abera;Ncayiyana, Jabulani;Levin, Jonathan
背景资料：10亿多人，主要是在低收入和中等收入国家，由于各种原因无法获得所需的保健服务。影响保健利用的可能因素包括社会人口和经济因素，如年龄、性别、教育、就业和收入。然而，不同的研究显示了不同的结果。此外，有有限的研究对health-care utilization.Objective：本研究旨在确定医疗保健利用和相关因素之间的所有居民年龄在18岁或以上的豪登province，SouthAfrica.Methods：一个横断面研究进行了收集的数据进行生活质量调查，这是由豪登城市地区天文台在2013年。使用简单随机抽样来选择参与者。共有27，490名参与者接受了访谈。数据是通过一个数字数据收集仪器使用一个开源系统称为Formhub收集的。粗化精确匹配（CEM）用于改善因果效应的估计。逐步多元Logistic回归分析，以确定与卫生保健utilization.Results相关的因素：约95.7%的报告通常利用医疗服务，而其他4.3%的报告没有寻求任何类型的医疗服务。大约75%的参与者报告说，公共卫生服务质量下降是不去看他们的主要原因。报告的医疗保健利用率较高的几率与女性有关（OR = 2.18，95% CI：1.88-2.53; p < 0.001），白色与非洲人相比（OR = 2.28，95% CI：1.84-2.74; p < 0.001），有医疗保险（OR = 5.41，95% CI：4.06-7.23; p < 0.001）。较低的几率寻求医疗保健与移民（OR = 0.61，95%CI：0.53-0.70; p < 0.001）。结论：结果表明，有必要提高公共卫生保健服务的质量和对他们的看法，提高医疗保健质量增加了医疗保健提供者的选择。
Background: More than a billion people, mainly in low- and middle-income countries, are unable to access needed health-care services for a variety of reasons. Possible factors influencing health-care utilization include socio-demographic and economic factors such as age, sex, education, employment and income. However, different studies have showed mixed results. Moreover, there are limited studies on health-care utilization.Objective: This study aimed to determine health-care utilization and associated factors among all residents aged 18 or over in Gauteng province, South Africa.Methods: A cross-sectional study was conducted from data collected for a Quality of Life survey which was carried out by Gauteng City-Region Observatory in 2013. Simple random sampling was used to select participants. A total of 27,490 participants have been interviewed. Data were collected via a digital data collection instrument using an open source system called Formhub. Coarsened Exact Matching (CEM) was used to improve estimation of causal effects. Stepwise multiple logistic regression was employed to identify factors associated with health-care utilization.Results: Around 95.7% reported usually utilizing health-care services while the other 4.3% reported not having sought health-care services of any type. Around 75% of participants reported reduced quality of public health services as a major reason not to visit them. Higher odds of reported health-care utilization were associated with being female (OR = 2.18, 95% CI: 1.88-2.53; p < 0.001), being White compared to being African ( OR = 2.28, 95% CI: 1.84-2.74; p < 0.001), and having medical insurance (OR = 5.41, 95% CI: 4.06-7.23; p < 0.001). Lower odds of seeking health-care were associated with being an immigrant (OR = 0.61, 95% CI: 0.53-0.70; p < 0.001).Conclusions: The results indicated that there is a need to improve the quality of public health-care services and perception towards them as improved health-care quality increases the choice of health-care providers.