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Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China

OBJECTIVE: To explore influential factors contributing to the choice of primary care facilities (PCFs) for the initial treatment among rural and urban residents in Southwestern China. METHODS: A face-to-face survey was conducted on a multistage stratified random sample of 456 rural and 459 urban res...

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Autores principales: Sun, Xiaxia, Meng, Hongdao, Ye, Zhiqiu, Conner, Kyaien O., Duan, Zhanqi, Liu, Danping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366770/
https://www.ncbi.nlm.nih.gov/pubmed/30730967
http://dx.doi.org/10.1371/journal.pone.0211984
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author Sun, Xiaxia
Meng, Hongdao
Ye, Zhiqiu
Conner, Kyaien O.
Duan, Zhanqi
Liu, Danping
author_facet Sun, Xiaxia
Meng, Hongdao
Ye, Zhiqiu
Conner, Kyaien O.
Duan, Zhanqi
Liu, Danping
author_sort Sun, Xiaxia
collection PubMed
description OBJECTIVE: To explore influential factors contributing to the choice of primary care facilities (PCFs) for the initial treatment among rural and urban residents in Southwestern China. METHODS: A face-to-face survey was conducted on a multistage stratified random sample of 456 rural and 459 urban residents in Sichuan Province from January to August in 2014. A structured questionnaire was used to collect data on residents’ characteristics, provider of initial treatment and principal reason for the choice. Multivariate logistic regression was performed to identify factors associated with choosing PCFs for the initial treatment. RESULTS: The result showed that 65.4% of the rural residents and 50.5% of the urban residents chose PCFs as their initial contact for medical care. Among both rural and urban residents, the principal reason for choosing medical institutions for the initial treatment was convenience (42.3% versus 40.5%, respectively), followed by high quality of medical care (26.5% versus 29.4%, respectively). Compared to rural residents, urban residents were more likely to value trust in doctors and high quality of medical care but were less likely to value the insurance designation status of the facilities. Logistic regression analysis showed that both rural and urban residents were less likely to choose PCFs for the initial treatment if they lived more than 15 minutes (by walk) from the nearest facilities (rural: OR = 0.15, 95%CI = 0.09–0.26; urban: OR = 0.19, 95%CI = 0.10–0.36), had fair (rural: OR = 0.49, 95%CI = 0.26–0.92; urban: OR = 0.31, 95%CI = 0.15–0.64) or poor (rural: OR = 0.14, 95%CI = 0.07–0.30; urban: OR = 0.22, 95%CI = 0.11–0.44) self-reported health status. Among rural residents, attending college or higher education (OR = 0.21, 95%CI = 0.08–0.59), being retired (OR = 0.90, 95%CI = 0.44–1.84) and earning a per capita annual income of household of 10,000–29,999 (OR = 0.24, 95%CI = 0.11–0.52) and 30,000–49,999 (OR = 0.26, 95%CI = 0.07–0.92) were associated with lower rates of seeking care at PCFs. CONCLUSION: Efforts should be made to improve the accessibility of PCFs and to upgrade the services capability of PCFs both in rural and urban areas in China. At the same time, resources should be prioritized to residents with poorer self-reported health status, and rural residents who retire or have better education and higher income levels should be taken into account.
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spelling pubmed-63667702019-02-22 Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China Sun, Xiaxia Meng, Hongdao Ye, Zhiqiu Conner, Kyaien O. Duan, Zhanqi Liu, Danping PLoS One Research Article OBJECTIVE: To explore influential factors contributing to the choice of primary care facilities (PCFs) for the initial treatment among rural and urban residents in Southwestern China. METHODS: A face-to-face survey was conducted on a multistage stratified random sample of 456 rural and 459 urban residents in Sichuan Province from January to August in 2014. A structured questionnaire was used to collect data on residents’ characteristics, provider of initial treatment and principal reason for the choice. Multivariate logistic regression was performed to identify factors associated with choosing PCFs for the initial treatment. RESULTS: The result showed that 65.4% of the rural residents and 50.5% of the urban residents chose PCFs as their initial contact for medical care. Among both rural and urban residents, the principal reason for choosing medical institutions for the initial treatment was convenience (42.3% versus 40.5%, respectively), followed by high quality of medical care (26.5% versus 29.4%, respectively). Compared to rural residents, urban residents were more likely to value trust in doctors and high quality of medical care but were less likely to value the insurance designation status of the facilities. Logistic regression analysis showed that both rural and urban residents were less likely to choose PCFs for the initial treatment if they lived more than 15 minutes (by walk) from the nearest facilities (rural: OR = 0.15, 95%CI = 0.09–0.26; urban: OR = 0.19, 95%CI = 0.10–0.36), had fair (rural: OR = 0.49, 95%CI = 0.26–0.92; urban: OR = 0.31, 95%CI = 0.15–0.64) or poor (rural: OR = 0.14, 95%CI = 0.07–0.30; urban: OR = 0.22, 95%CI = 0.11–0.44) self-reported health status. Among rural residents, attending college or higher education (OR = 0.21, 95%CI = 0.08–0.59), being retired (OR = 0.90, 95%CI = 0.44–1.84) and earning a per capita annual income of household of 10,000–29,999 (OR = 0.24, 95%CI = 0.11–0.52) and 30,000–49,999 (OR = 0.26, 95%CI = 0.07–0.92) were associated with lower rates of seeking care at PCFs. CONCLUSION: Efforts should be made to improve the accessibility of PCFs and to upgrade the services capability of PCFs both in rural and urban areas in China. At the same time, resources should be prioritized to residents with poorer self-reported health status, and rural residents who retire or have better education and higher income levels should be taken into account. Public Library of Science 2019-02-07 /pmc/articles/PMC6366770/ /pubmed/30730967 http://dx.doi.org/10.1371/journal.pone.0211984 Text en © 2019 Sun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sun, Xiaxia
Meng, Hongdao
Ye, Zhiqiu
Conner, Kyaien O.
Duan, Zhanqi
Liu, Danping
Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title_full Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title_fullStr Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title_full_unstemmed Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title_short Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China
title_sort factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in southwestern china
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366770/
https://www.ncbi.nlm.nih.gov/pubmed/30730967
http://dx.doi.org/10.1371/journal.pone.0211984
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