Medical-care-seeking Behavior of Illness-caused Poverty Patients in Rural Areas and the Influencing Factors

Abstract

Objective: To investigate the medical-care-seeking behavior of illness-caused poverty patients in rural areas and the influencing factors, with a view to provide references for the formulation of relevant policy.

Methods: Using convenience sampling method, we selected Miyi County of Sichuan Province, Xingtai County of Hebei Province and Binhai County of Jiangsu Province to conduct investigations. After stratification based on income level, we selected 6 towns in Miyi County of Sichuan Province, 6 towns in Xingtai County of Hebei Province and 3 towns in Binhai County of Jiangsu Province. We randomly selected 4 to 6 administrative villages in each village and town and enrolled illness-caused poverty patients with the aid of village heads. From July to August in 2013, self-designed questionnaire was employed to carry out household investigation, and the questionnaire content included the basic information of patients, the medical-care-seeking behavior of patients, and family information. A total of 453 effective questionnaires were distributed in 3 counties, with 209 in Miyi County, 166 in Xingtai County and 78 in Binhai County.

Results: Among 453 patients, the numbers of patients who chose to conduct self-treatment, visit doctors after self-treatment, visit doctors directly and seek no treatment were 15 (3.3%), 230 (50.8%), 136 (30.0%) and 72 (15.9%); the numbers of patients who chose private clinics, village health centers, township health centers, and county-level or superior hospitals as the medical setting to receive first diagnosis were 47 (10.7%), 107 (24.4%), 163 (37.2%) and 121 (27.7%). The subjects in Miyi County, Xingtai County and Binhai County were significantly different in the treatment mode and the choice of medical setting to receive initial diagnosis (P＜0.05). Patients with different age, marital status, relation with householder, education background, self-assessment of health, living place per capita, cultivated land per capita, asset per capita, household expenditure per capita, proportion of medical expenditure in the all domestic expenditure, the average outpatient expenditure, the major payment method of outpatient service, the distance from home to the nearest medical setting and time spent on the road from home to the nearest medical setting are significantly different in the treatment mode and the choice of medical setting to receive initial diagnosis (P＜0.05).

Conclusion: Illness-caused poverty patients in rural areas tend to seek medical care in medical settings of higher levels, the major influencing factors for the medical-care-seeking behaviors of these patients are the basic information, family economic status, medical economic burden and the accessibility to medical settings.