Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study
Objective To assess the willingness and factors influencing the choice of primary healthcare (PHC) institutions among patients with chronic conditions in China.Design A nationwide population-based study with binary logistic regression was conducted and used to estimate the ORs of the influencing fac...
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BMJ Publishing Group
2022-03-01
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| author | Li Teng Yueping Li |
| author_facet | Li Teng Yueping Li |
| author_sort | Li Teng |
| collection | DOAJ |
| description | Objective To assess the willingness and factors influencing the choice of primary healthcare (PHC) institutions among patients with chronic conditions in China.Design A nationwide population-based study with binary logistic regression was conducted and used to estimate the ORs of the influencing factors of health-seeking at PHC institutions using the Anderson model as a theoretical framework.Setting The China Family Panel Studies (CFPS) database.Participants The study sample included 7967 patients with chronic conditions identified from the 2016 and 2018 CFPS databases.Results From 2016 to 2018, the rate of choosing PHC institutions for patients with chronic conditions dropped from 51.0% to 47.7%. The logistic regression results showed that patients with low family income (OR value of >60 000 group was 0.57, 95% CI 0.43 to 0.74), low education level (OR value of bachelor degree or above was 0.54, 95% CI 0.35 to 0.83;), older age (OR value of >65 group was 1.31, 95% CI 1.08 to 1.60;), hypertension and diabetes (OR 1.26, 95% CI 1.13 to 1.41), living in rural areas (OR value of urban was 0.47, 95% CI 0.38 to 0.60), immigrating from rural to urban areas (OR 1.64, 95% CI 1.26 to 2.13), reporting good health (OR value of very good was 1.33, 95% CI 1.05 to 1.68) and those from areas with a high proportion of PHC institutions (OR 1.05, 95% CI 1.02 to 1.07) were more inclined to choose PHC institutions. Conversely, patients with urban employee health insurance (OR 0.62, 95% CI 0.49 to 0.80) and more than one chronic disease (OR 0,83, 95% CI 0.75 to 0.92) preferred choosing a hospital.Conclusions The patients’ willingness to choose PHC institutions was low. The health-seeking preference of patients with chronic conditions is derived from medical needs and is influenced by the predisposing factors and tendencies of enabling resources. Measures should be taken to improve the capacity of PHC institutions. |
| format | Article |
| id | doaj-art-cdedf2a33f2f4bdea71ad777d852c125 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-cdedf2a33f2f4bdea71ad777d852c1252025-08-20T02:17:40ZengBMJ Publishing GroupBMJ Open2044-60552022-03-0112310.1136/bmjopen-2021-054783Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional studyLi Teng0Yueping Li1The school of Public Health, Fujian Medical University, Fuzhou, ChinaThe school of Public Health, Fujian Medical University, Fuzhou, ChinaObjective To assess the willingness and factors influencing the choice of primary healthcare (PHC) institutions among patients with chronic conditions in China.Design A nationwide population-based study with binary logistic regression was conducted and used to estimate the ORs of the influencing factors of health-seeking at PHC institutions using the Anderson model as a theoretical framework.Setting The China Family Panel Studies (CFPS) database.Participants The study sample included 7967 patients with chronic conditions identified from the 2016 and 2018 CFPS databases.Results From 2016 to 2018, the rate of choosing PHC institutions for patients with chronic conditions dropped from 51.0% to 47.7%. The logistic regression results showed that patients with low family income (OR value of >60 000 group was 0.57, 95% CI 0.43 to 0.74), low education level (OR value of bachelor degree or above was 0.54, 95% CI 0.35 to 0.83;), older age (OR value of >65 group was 1.31, 95% CI 1.08 to 1.60;), hypertension and diabetes (OR 1.26, 95% CI 1.13 to 1.41), living in rural areas (OR value of urban was 0.47, 95% CI 0.38 to 0.60), immigrating from rural to urban areas (OR 1.64, 95% CI 1.26 to 2.13), reporting good health (OR value of very good was 1.33, 95% CI 1.05 to 1.68) and those from areas with a high proportion of PHC institutions (OR 1.05, 95% CI 1.02 to 1.07) were more inclined to choose PHC institutions. Conversely, patients with urban employee health insurance (OR 0.62, 95% CI 0.49 to 0.80) and more than one chronic disease (OR 0,83, 95% CI 0.75 to 0.92) preferred choosing a hospital.Conclusions The patients’ willingness to choose PHC institutions was low. The health-seeking preference of patients with chronic conditions is derived from medical needs and is influenced by the predisposing factors and tendencies of enabling resources. Measures should be taken to improve the capacity of PHC institutions.https://bmjopen.bmj.com/content/12/3/e054783.full |
| spellingShingle | Li Teng Yueping Li Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study BMJ Open |
| title | Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study |
| title_full | Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study |
| title_fullStr | Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study |
| title_full_unstemmed | Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study |
| title_short | Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study |
| title_sort | analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in china a cross sectional study |
| url | https://bmjopen.bmj.com/content/12/3/e054783.full |
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