Outpatient healthcare-seeking behavior and influencing factors among residents in Guangdong Province: An analysis based on the seventh national health service survey in 2023^☆

Abstract

Background: The tiered healthcare delivery system is a crucial component in deepening healthcare reform. Analyzing the healthcare-seeking choices of outpatients and their influencing factors from the demand-side perspective, based on real-world data, holds significant practical importance for advancing the tiered healthcare system and promoting the high quality development of healthcare services.

Objective: To identify outpatient healthcare-seeking behavior and influencing factors among residents of Guangdong Province in the context of tiered healthcare system. The report is for supporting policies on rational healthcare utilization.

Methods: Data were obtained from the Seventh National Health Service Survey in 2023, covering eight sampled counties (districts/cities) of Guangdong Province. Descriptive statistics were performed using frequencies and proportions. Univariate analysis was conducted using the Chi-square test, followed by multivariable logistic regression, with “whether patients choose first contact at primary care facilities for sickness within two-weeks” as the dependent variable, variables with statistical significance in univariate analysis (P<0.05) were included in the regression model.

Results: In total, 72.2% patients choose first contact at primary care facilities within two-weeks. Patients in rural areas(OR=1.561, 95% CI: 1.170-2.082), proximity to a primary care facility (OR=3.870, 95% CI: 2.915-5.136), enrollment in urban-rural resident basic medical insurance (OR=2.209, 95% CI: 1.695-2.879), and perceived mild illness (OR=3.458, 95% CI: 2.449-4.883) are more likely to choose primary care facility, while those with education levels above high school (OR=0.498, 95% CI: 0.293-0.847) and didn’t contract with a family doctor (OR=0.671, 95% CI: 0.504-0.894) were more likely to seek care at general hospitals.

Conclusion: The majority of Guangdong residents preferred primary care facility for first contact, but there is still a space of improvement. Both environmental and individual factors significantly influence healthcare-seeking choices. Efforts should focus on optimizing the distribution and accessibility of primary care facilities, strengthening service capacity and management efficiency, to promote rational healthcare utilization of residences.

Keywords

Healthcare-seeking behavior / Influencing factors / Tiered healthcare system

Competing interests

All authors declare that there are no competing interests

Declarations

Not applicable.

Authors' contributions

Conceptualization, C.L.; Methodology, C.L.; Data curation, H.W.; Formal analysis, H.W.; Funding acquisition, not applicable; Project administration, not applicable; Resources, not applicable; Supervision, Y.B.; Validation, Y.B.; Writing—original draft, C.L.; Writing—review and editing, Y.B. All authors have read and agreed to the published version of the manuscript.

Ethical approval and consent to participate

The study received approval from Ethics Committee of the Fifth People's Hospital of Chengdu (Approval No: Lunsen 2021-071 (Ke)-01).

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

This research was supported by grants from the Health Commission of Guangdong Province (C2024051) and Guangdong Provincial Clinical Medical Scientific Data Center (2024B1212070015).

Acknowledgements

Not applicable.

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