How health seeking behavior develops in patients with type 2 diabetes: a qualitative study based on health belief model in China.

Background: Type 2 diabetes(T2DM) is a global health problem which is accompanied with multi-systemic complications, and associated with long-term health burden and economic burden. Effective health seeking behavior (HSB) refers to reasonably utilize health resources, effectively prevent and treat diseases, and maintain health. Effective health seeking behavior (HSB) is vital to mitigate the risk of T2DM complications. However, health seeking behavior for T2DM patients remains sub-optimal worldwide. Objective: The study aimed to explore the internal logic of how health seeking behavior of T2DM patients develops and the influencing factors of health seeking behavior. With a view to provide a reference basis for improving the health seeking behavior situation of T2DM patients. Methods: This study was conducted at an integrated tertiary hospital in China. People who were diagnosed with T2DM, capable of expressing clearly and had no mental illness, were approached based on a purposive sampling. The experience of T2DM and health seeking behavior were collected via in-depth interviews. A theory-driven thematic analysis based on Health Belief Model (HBM) was applied for data analysis. Inductive reasoning was used to identify emerging themes which were not included in HBM. Results: 26 patients with T2DM were included in the current study. Seven themes were identified, including: (1) T2DM diagnosis and severity; (2) T2DM treatment and management; (3) Perceived susceptibility of diabetes progression; (4) Perceived severity of diabetes progression; (5) Perceived benefits of health seeking behavior; (6) Perceived barriers of health seeking behavior; (7) Perception of behavioral cues. Generally, patients with T2DM lacked reliable sources of information, considered T2DM to be slow-progressing and without posing an immediate threat to life. Consequently, they did not fully grasp the long-term risks associated with T2DM or the protective effects of health seeking behavior. Conclusion: This study highlighted the challenges in health seeking behavior for patients with T2DM. It suggested that future interventions and strategies should involve multi-faceted approaches, targeting healthcare providers (HCPs), patients with T2DM, and their support networks. This comprehensive strategy can help patients better understand their condition and the importance of effective health seeking behavior. Ultimately, enhancing their capacity for adopting appropriate health-seeking practices.

Prevalence of traditional eye medicine and self-treatment in Gurage Zone, Rural Ethiopia.

INTRODUCTION: Traditional medicines are commonly used worldwide, especially in Africa-however, there is limited information on the prevalence and types of traditional eye medicine utilization in Ethiopia. The goal of this study was to determine the prevalence, the type and nature of traditional eye medicine use and practices related to self-medication for ophthalmic diseases in a rural Ethiopian population. METHODS: A cross-sectional study was conducted in six randomly selected primary health centers in rural Gurage Zone, Southern Ethiopia. Health-seeking behavior, use of self-medication, and traditional eye medicine were assessed in the population using a semi-structured questionnaire. Descriptive statistics and multivariable logistic regression analysis were computed to determine associated factors for using self-medication and traditional eye medicine. RESULT: Of the 814 participants interviewed, 487 (59.8%) reported using traditional eye medicine, mainly for combinations of symptoms of ocular redness, irritation, and eye discharge (95.5%). Besides, 604 (74.2%) participants reported self-treatment with tetracycline 1% eye ointment. Older age, females, low income, no formal education, and lack of access to media were risks for utilizing traditional eye medicine. CONCLUSION: The use of traditional eye medicine and self-treatment are common in this population. Regulatory legislation, public awareness, and making eye care are vital activities required to monitor such practices.

Insights into determinants of health-seeking behavior: a cross-sectional investigation in the Iraqi context.

Background: Health-seeking behavior (HSB) is a choice taken by an individual to maintain, achieve, or restore good health and prevent diseases. The purpose of this study is to examine the determinants of HSB among the Iraqi population. Methods: This cross-sectional study in the Rusafa and Karkh districts of Baghdad investigated determinants of HSB from 2022 to 2023. With a sample size of 993 participants meeting inclusion criteria, data were collected through a self-reported questionnaire, utilizing four indicators to measure HSB. The study employed various statistical methods especially logistic regression models, facilitated by Stata 17 software. Results: Results highlights that married individuals consistently have higher odds of having HSB compared to their single counterparts, with an odds ratio (OR) of 2.09 (95% confidence interval: 1.41-3.10). This relationship remains robust even after controlling for other variables. Furthermore, individuals with higher social class exhibit stronger connections to HSB, although the OR is 1.69 (95% CI: 0.47-6.13), indicating a wide confidence interval. Regarding underlying diseases and their duration, the results indicate that chronic diseases are associated with a higher likelihood of HSB, with an OR of 2.05 (95% CI: 1.35-3.11). Additionally, a longer duration of diseases in terms of years is also linked to a stronger association with HSB, with an OR of 2.86 (95% CI: 1.32-6.23). Conclusion: In conclusion, this work provides important insights into HSB. Married people are continuously more likely to engage in HSB than single people, highlighting the importance of customized interventions. Furthermore, persons from higher social classes have stronger ties to HSB, highlighting the importance of socioeconomic considerations. The link between HSB and chronic diseases, combined with longer disease durations, emphasizes the importance of early detection and thorough healthcare management. These findings give critical guidance for healthcare providers, marketers, and politicians developing effective initiatives to promote HSB.

Factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia.

BACKGROUND: Health-seeking behavior (HSB) involves any action or inaction taken by individuals who perceive themselves to have a health problem or illness aimed at finding appropriate medical treatments. Studies suggest a positive relationship between the availability and quality of health services and their utilization. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, to improve healthcare access and health outcomes. METHOD: A cross-sectional study was conducted targeting Sudanese residents of the Kingdom of Saudi Arabia (KSA). Participants were recruited using convenient sampling. A self-administered questionnaire was distributed electronically. A total of 494 participants were recruited for the study. RESULTS: This study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Significant factors influencing health-seeking behavior included age (OR [95% CI]: 1.032 [1.000-1.066]) and lack of health insurance (OR = 1.01, 95% CI [1.00-1.02], p = 0.019). CONCLUSIONS: This study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese immigrants in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services.

Parents' Attitude Towards Their Feverish Children in Buraydah, Saudi Arabia.

BACKGROUND: Fever is a very common problem among pediatric age groups globally. Parents' adequate knowledge and practice make a huge difference in the areas of cost as well as time. The objective of this study is to determine parents' knowledge and practice about their feverish child and the socio-demographic characteristics associated with such knowledge and practice. METHODS: A cross-sectional study was conducted among 194 parents attending primary healthcare centers (PHCs) by using a convenient sampling method. Informed consent was obtained from each participant. Data were collected through a validated self-administered questionnaire and later analyzed with SPSS software. For inferential statistics, the chi-square test was applied. RESULTS: Of the 194 participants in our study, 59.8% were men (n=116) and 40.2% were women (n=78). About 37.1% (n=72) of parents had defined the maximum normal temperature for children as 37.5°C. Additionally, 71.6% (n=139) of the parents were concerned about convulsions in feverish children. Approximately 39.2% (n=76) of parents considered PHC doctors to be their source of information. About 70.1% (n=136) of participants applied cold compresses when their child developed a fever. Nearly 88.1% (n=171) of parents preferred to visit the doctor when their child had a high fever. There was a statically significant association observed between occupation categories and source of information (P<0.05). CONCLUSION: Based on the study results, it was found that parents had poor knowledge about defining the normal body temperature. Approximately two-thirds of the study participants had good practices about health-seeking behavior.

The relationship between health literacy and health-seeking behavior amongst university students in Ghana: A cross-sectional study.

Background and Aims: The crises of the last decades have provided more evidence of the need for health literacy as a measure of resilience and preparedness. In this study the relationship between health literacy and health-seeking behavior was investigated. Methods: This study used a cross-sectional design with a questionnaire of five sections dedicated to health-seeking behavior, health literacy, family background, socioeconomic status and demographics. Health-seeking behavior was used in three dimensions namely preference for hospitals, self-medication, and herbal medicine. The questionnaire was completed by 262 students at the University of Ghana. Results: A significant linear regression model (R = 0.39, R² = 0.15, Adjusted R² = 0.13, F = 8.89, p < 0.001) supported the relationship between health literacy and health-seeking in health facilities such as hospitals. A Pearson correlation further showed an association between self-medication and preference for herbal medication. Conclusion: Findings support the crucial role of health literacy in timely hospital visits by patients. This implies the need to improve health literacy through education, policy, and research. This can promote prevention of diseases through timely health-seeking and improve preparedness against health crises. The study suggests health literacy should be integrated into educational curricula and regular health campaigns run by public health agencies.

Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study.

Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.

Factors Associated with Mothers Health Seeking Behavior among Newborn Illness.

BACKGROUND: Inappropriate, delayed and poor health seeking behavior increases the high risk of morbidity and mortality among newborns, infants and children. Newborns health status depends upon mothers' health seeking behavior. This study aimed to determine the factors associated with mother's health seeking behavior among newborn illness in Rupandehi District, Nepal. METHODS: Community based cross-sectional study among 372 mothers aged 15-49 years was conducted in Rupandehi district Nepal from May to November 2019. Multistage probability random sampling was used as the sampling technique. Siddharthanagar municipality and Mayadevi rural municipality were selected randomly among 16 local units of Rupandehi district. Two wards from each unit were selected by stratified random sampling using non replacement lottery method. As the sample size was 372, ninety three respondents were selected randomly from each ward. RESULTS: The mean age and standard deviation of mothers was 25.32±4.36 years respectively. Among 372 mothers, 21.24% had poor health seeking behavior. Mothers having more than one child (AOR=0.15; CI: 0.02-0.98), primary and above education (AOR=8.89; CI: 3.15-25.08), visited hospital after 24 hours of newborn illness (AOR=13.59; CI: 1.73-106.7), knew danger signs of newborn (AOR=18.74; CI: 5.65-62.23), practiced exclusive breastfeeding (AOR=8.20; CI: 3.36-20.03) were significantly associated with health seeking behavior. CONCLUSIONS: Almost 22 % of mothers had poor health seeking behavior regarding their newborn illness. Number of living child, education of mother, appropriate time for treatment, receive health services when there is dangers signs of newborn and exclusive breast feeding practice were independent factors associated with mother's health seeking behavior. Hence, decision-makers and local administrator should provide specific intervention to newborns' mother regarding family planning, identifying and preventing danger signs of newborn, importance of appropriate time of treatment and exclusive breastfeeding.

Eye Care Service Use and Associated Health-Seeking Behaviors Among Malawian Adults: Secondary Analysis of the Malawi Fifth Integrated Household Survey 2019-2020.

Background: The use of eye care services varies among different population groups. Objective: This study aimed to assess self-reported eye care use (ECU) and associated demographic factors among Malawian adults. Methods: This study used secondary data from the Malawi Fifth Integrated Household Survey 2019-2020, a nationally representative survey. The study included 12,288 households and 27,336 individuals 15 years and older. We entered age, sex, level of education, residency (urban/rural), and chronic disease into a logistic regression model, and used a confusion matrix to predict the model's accuracy. A P value <.05 was considered statistically significant. Results: About 60.6% (95% CI 60.0%-61.2%) of those with eye problems accessed formal care 2 weeks before the survey date. A logistic regression model showed that ECU was positively associated with education compared to none (odds ratio [OR] 6.6, 95% CI 5.927-7.366; P<.001), males compared to females (OR 1.2, 95% CI 1.104-1.290; P<.001), and urban residence compared to rural (OR 1.2, 95% CI 1.118-1.375; P<.001). ECU was negatively associated with age (OR 7, 95% CI 6.782-8.476; P<.001) and having chronic diseases (OR 0.6, 95% CI 0.547-0.708; P<.001). Conclusions: Social support, women empowerment, education, and mobile clinics are key strategic areas that would increase access to eye care in Malawi. Further studies can investigate ECU among the pediatric population.

The influence of COVID-19 on health seeking behaviors among students attending a minority-serving institution in the U.S.

Objective: The goal of this research was to examine the effects of COVID-19 on health seeking behaviors among students attending a minority-serving institution (MSI). Participants: Students [N = 580, Mage (SD) = 27.7 ± 9.1 years] from a midsized university in the U.S. Methods: Cross-sectional survey, distributed between February-March 2021, assessing visits with a healthcare professional before and during the pandemic. Comparison by time and between groups using McNemar's test and ordinal logistic regression. Results: In-person medical care decreased during the pandemic (p = 0.096). Higher frequency of doctor visits pre-pandemic resulted in less contact with students' healthcare providers during the pandemic (p < 0.001). Those that indicated their health status as Excellent were mostly likely to visit their healthcare provider in-person during the pandemic (p = 0.026). Virtual contacts with their healthcare provider increased during the pandemic (p < 0.001). Conclusions: The COVID-19 pandemic has changed health seeking behaviors among students attending an MSI.

Examining Health-Seeking Behavior among Diverse Ethnic Subgroups within Black Populations in the United States and Canada: A Cross-Sectional Study.

The Black populations, often treated as ethnically homogenous, face a constant challenge in accessing and utilizing healthcare services. This study examines the intra-group differences in health-seeking behavior among diverse ethnic subgroups within Black communities. A cross-sectional analysis included 239 adults ≥18 years of age who self-identified as Black in the United States and Canada. Multiple logistic regression assessed the relationship between health-seeking behaviors and ethnic origin, controlling for selected social and health-related factors. The mean age of the participants was 38.6 years, 31% were male, and 20% were unemployed. Sixty-one percent reported a very good or excellent health status, and 59.7% were not receiving treatment for chronic conditions. Advancing age (OR = 1.05, CI: 1.01-1.09), female gender (OR = 3.09, CI: 1.47-6.47), and unemployment (OR = 3.46, CI: 1.35-8.90) were associated with favorable health-seeking behaviors. Compared with the participants with graduate degrees, individuals with high school diplomas or less (OR = 3.80, CI: 1.07-13.4) and bachelor's degrees (OR = 3.57, CI: 1.3-9.23) were more inclined to have engaged in favorable health-seeking behavior compared to those with graduate degrees. Across the Black communities in our sample, irrespective of ethnic origins or country of birth, determinants of health-seeking behavior were age, gender, employment status, and educational attainment.

Health-seeking behaviors and determinants among herpes zoster patients in South Wollo public hospitals, Ethiopia, 2022.

Background: Health-seeking behavior towards herpes zoster is vital to find an appropriate remedy for patients and utilization of timely healthcare services can have an impact on good health outcomes. The study aimed to assess the health-seeking behavior and determinants among Herpes Zoster patients in public hospitals, South Wollo, Ethiopia. Method: A hospital-based cross-sectional study was conducted from September 1, 2022, to November 30, 2022. The simple random sampling technique was used to select 419 participants. Pretested, structured questionnaires and patient interviews were used to collect the data. The bivariable analysis was done and variables with p-value <0.25 were further examined using a multivariable logistic regression model. AOR with a 95 % CI and a P-value <0.05 at a 5 % level of significance were considered. Results: About 55.6 % of patients had poor health-seeking behavior towards herpes zoster, with a response rate of 99.1 %. Distance from health facilities (AOR = 4.9; 95 % CI: 1.33-10.35), being rural residence (AOR = 0.3; 95 % CI: 0.17-0.40), being illiterate (AOR = 5.9; 95 % CI: 3.40-10.32), poor self-care adherence (AOR = 1.8; 95 % CI = 1.14-3.07), moderate depression (AOR = 7.3; 95 % CI: 4.10-11.50), moderate (AOR = 0.3; 95 % CI: 0.10-0.70) and severe anxiety (AOR = 0.1; 95 % CI: 0.01-0.63), and duration more than seven days of herpes zoster (AOR = 3.1; 95 % CI = 1.42-6.97) were statistically significant. Conclusion: Nearly half of the study participants had poor health-seeking behavior. Being a rural resident and illiterate, poor self-care adherence, moderate and severe anxiety, moderate depression, and duration of more than 7 days were significantly associated. with health-seeking behavior towards Herpes Zoster. Proper guidance, psychological support, and awareness creation about Herpes Zoster severity and complications.

Health-Seeking Behaviour and Its Determinants Following the COVID-19 Pandemic.

OBJECTIVE: The purpose of this study was to determine the change in behaviour of individuals towards any health issues they faced after the coronavirus disease 2019 (COVID-19) pandemic and to compare the health-seeking behaviour of people who were infected by the virus and those who were not infected. METHODS: A cross-sectional study was conducted among 400 participants visiting Shifa International Hospital, Islamabad, Pakistan, and Pakistan Institute of Medical Sciences Hospital, Islamabad, Pakistan. Data was collected through a pilot-tested questionnaire and analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). RESULTS: In 286 participants (71.6%), health-seeking behaviours were significantly altered by the COVID-19 pandemic. Overall, this research showed that COVID-19 was linked to poor health-seeking behaviour. CONCLUSION: Most of the participants' health-seeking behaviours were significantly altered by the COVID-19 pandemic. A significant change in how people behaved towards any health problem was reported. As a result, public awareness campaigns should focus on delivering more information about COVID-19 to promote their health-seeking behaviour.

Beyond Borders: Exploring the Quality of Life, Health-Seeking Behavior, and Perceived Barriers in Health Services Utilization Among Sudanese Immigrants in Egypt.

BACKGROUND: The detention of immigrants has adverse effects on both their health and their overall quality of life. In migration conditions, there is a notable impact on health-seeking behavior. OBJECTIVE: This study aims to explore the quality of life, health-seeking behavior, and perceived barriers to health services utilization among Sudanese immigrants in Egypt. MATERIALS AND METHODS: The study employed a cross-sectional design to fulfill its objectives. A convenience sample comprising 385 Sudanese immigrants post-war was utilized. The researcher employed a structured questionnaire consisting of four parts: socio-demographic data, a quality of life questionnaire, an assessment of health-seeking behavior, and an exploration of the barriers faced by Sudanese immigrant participants in accessing health services. RESULTS: The study on Sudanese immigrants post-war revealed diverse perceptions of overall quality of life, with 41.6% reporting satisfaction, 32.4% an average state, and 26.0% unsatisfactory conditions. Factors such as gender, educational level, financial situation, and the primary reason for relocating to Egypt significantly influenced these outcomes (p<0.05). Encouragingly, 57.1% of the immigrants exhibited positive health-seeking behavior. Noteworthy barriers to healthcare access included limited awareness of available services (60.5%), competing priorities like work (53.2%), insufficient financial resources (49.6%), and extended waiting times in healthcare facilities (45.5%). These findings underscore the complex interplay of factors affecting the well-being and health-seeking patterns of Sudanese immigrants in their new environment. CONCLUSION: The research sheds light on key aspects of the well-being of Sudanese immigrants in Egypt, offering insights into their quality of life, health-seeking behavior, and perceived barriers to healthcare. The findings reveal a diverse spectrum of overall quality of life, with over a third expressing satisfaction, while a significant portion reported average or unsatisfactory levels. The study underscores the intricate influence of gender, educational level, financial situation, and the primary reason for immigration on the quality of life. Positive health-seeking behavior was observed in more than half of the participants, yet the identification of barriers to healthcare access signals challenges that warrant attention for enhancing overall health outcomes among this immigrant population. Implementing community-based health education programs plays a pivotal role in empowering immigrant Sudanese individuals in Egypt to make informed health choices and adopt healthy lifestyles.

Utilization of opportunistic cervical cancer screening in Nigeria.

BACKGROUND: While various interventions have been conducted to decrease cervical cancer's burden in Nigeria, no study has examined the trends in cervical cancer screening uptake over time. The present study sought to fill this gap in knowledge using data collected at Jos University Teaching Hospital (JUTH) in Nigeria. METHODS: Data collected continuously between 2006 and 2016 were analyzed to identify trends in screening uptake, changes in risk factors for cervical cancer, and to identify factors for women screened at Jos University Teaching Hospital (JUTH) in Jos, Nigeria. Categorical analyses and logistic regression models were used to describe patient characteristics by year, and to identify factors associated with repeated screening uptake. RESULTS: A total of 14,088 women who were screened between 2006 and 2016 were included in the database; 2,800 women had more than one screening visit. Overall, screening uptake differed significantly by year. On average women were first screened at age 38. About 2% of women screened were women living with HIV. Most women (86%) had normal pap smear at first screening, with the greatest decreased risk of abnormalities observed between 2011 and 2014. Odds of a follow-up screening after a normal result decreased significantly between 2008 and 2016 compared to women screened in 2006 and 2007. Finally, women living with HIV had increased odds of follow-up screening after having a normal pap smear. CONCLUSIONS: These findings contribute to our understanding of the potential social and health system barriers to cervical cancer control in Nigeria. The findings may assist policy makers to design interventions to increase access and compliance to recommended screening schedules in this vulnerable population.

Outpatient health service utilization and its influencing factors among pneumoconiosis patients combined with tuberculosis / 环境与职业医学

Background Tuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. Objective To understand the outpatient health service utilization for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. Methods A stratified random sampling combined with non-random sampling was used to select 11181 pneumoconiosis patients in 27 provincial administrative regions (excluding Shanghai, Tianjin, Hainan, Tibet Autonomous Region, Taiwan, Hongkong and Macao Special Administrative Regions) from December 2017 to June 2021. A self-constructed questionnaire, i.e. Health Seeking Behaviors of Pneumoconiosis Patients and Their Influencing Factors, was used, which included basic information, outpatient and inpatient service utilization, and influencing factors of medical treatment behaviors of pneumoconiosis patients. The effective recovery rate of the questionnaire was 90.7%. All patients of pneumoconiosis combined with tuberculosis (n=762) were included as the study subjects. The difference of outpatient utilization in the past two weeks, choosing medical institutions, and the reasons of not seeking medical treatment between urban and rural areas, and the influencing factors of outpatient service utilization were analyzed. Results The study subjects were mainly silicosis combined with tuberculosis (502 cases, 65.9%) and coal workers' pneumoconiosis combined with tuberculosis (232 cases, 30.5%), aged (58.6±12.5) years old. The main region was Western China (45.1%), followed by Eastern China (22.1%), Centeral China (20.2%), and Northeastern China (12.6%). The outpatient utilization rate in the past two weeks was 38.5% (293/762), and the main medical institutions consulted were municipal or provincial hospitals (32.0%), district or county hospitals (28.6%), and township hospitals or health service centers (17.5%). Short distance (20.7%), the availability of specialist outpatient services (16.7%), high level of medical care (14.8%), and low medical cost (12.3%) were the main reasons in choosing medical institutions. Higher proportion of patients seeking medical services due to acute exacerbation in rural areas was reported than in urban areas in the past two weeks (P<0.01). In addition to being hospitalized (113 cases, 41.4%) and self-purchasing medicine (46 cases, 16.8%), the reasons for not seeking medical treatment were self-perceived mild symptoms (15.0%) and high medical cost without reimbursement (9.5%). The multiple regression results showed that outpatient rate for patients of pneumoconiosis combined with tuberculosis in the western region was higher than that in the eastern region (OR=1.66, 95%CI: 1.03, 2.68); patients with an annual personal income of 10000-35500 yuan had a higher outpatient rate than the > 35500 yuan income group (OR=2.54, 95%CI: 1.49, 4.36); the outpatient rate of silicosis patients was higher than that of coal workers' pneumoconiosis (OR=1.83, 95%CI: 1.23, 2.72); the outpatient rate of patients with clinically diagnosed cases (no classified stage of pneumoconiosis) was higher than that of patients with stage I pneumoconiosis (OR=2.32, 95%CI: 1.24, 4.31). Exacerbation of pneumoconiosis-related symptoms in past two weeks (OR=4.26, 95%CI: 2.89, 6.28), occupational injury insurance (OR=0.49, 95%CI: 0.30, 0.80), and hospitalization in past one year (OR=2.37, 95%CI: 1.41, 3.97) were the main factors influencing the outpatient health service utilization among patients of pneumoconiosis combined with tuberculosis. Conclusion The outpatient rate of patients of pneumoconiosis combined with tuberculosis is higher than that of patients of pneumoconiosis without tuberculosis. The utilization of outpatient services is related with disease factors and socio-economic security factors.

Health-seeking behavior among non-communicable disease patients globally, systematic review and meta-analysis.

Introduction: Non-communicable disease contributes to over 42 million deaths worldwide and it is estimated that 86% of non-communicable disease-related mortalities happen in low and middle-income countries. Understanding health-seeking behaviors like initiating care at the right time, with the right provider and maintaining regularity of care seeking is a prelude for a successful management of non-communicable diseases. Therefore, the aim of this systematic review and meta-analysis was to assess the pooled prevalence of health-seeking behavior for non-communicable disease and associated factors worldwide. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist guideline was followed for this review and meta-analysis. Electronic data base, PubMed, EMBASE, Medline, Web of science, Google scholar and Science direct were used to retrieve studies reported in English language with publication year since 2018 worldwide. Studies reporting proportion of health-seeking behavior for non-communicable disease were evaluated. The pooled prevalence, odds ratio and confidence interval were calculated using Stata version 17 software. The quality of studies included in this review was checked using modified Newcastle-Ottawa scale for observational study checklist. Result: Ten studies which involved 63,498 patients with non-communicable disease were included in this review. The pooled estimated proportion of health-seeking behavior among non-communicable diseases patients from health facilities were 56% (95% CI: 44-68). Older age > 60, urban residency, being of female gender, high educational status, getting support during treatment, knowledge on non-communicable disease, having more than one non-communicable disease, presences of health insurance and middle and upper economic class were factors positively associated with health-seeking behavior for non-communicable diseases. Conclusion: Despite the fact that more than half of patients with non-communicable diseases have health-seeking behavior in health facilities, still, there are a considerable number of individuals with non-communicable diseases having no health-seeking behavior worldwide. Therefore, organizations working for the welfare of human betterment would do well in implementing strategies that could improve health-seeking behavior that would help to reduce the burdens on health systems and prevent premature death from non-communicable diseases.

The action logic of the older adults about health-seeking in South Rural China.

BACKGROUND: The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. METHODS: Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. RESULTS: Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) 'unpredictable' troubles: they tended to favor the 'optimal' solution of keeping their lives in order rather than the best medical treatment options. CONCLUSION: This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the 'inaccessibility' of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education.

The Pattern of Health-Seeking Behavior among Juang Tribe- A Particularly Vulnerable Tribal Group of Odisha, India.

Introduction: Social and economic position, environment, access to healthcare, ethos, and worldview are all important determinants of people's health-seeking behavior. Tribal communities in India oscillate between their emic rationale for the cause and treatment of health concerns on the one hand and affordable modern methods on the other. The present article is based on a study conducted among the Junag tribe of Odisha to understand their acceptance and preference for traditional or modern healthcare systems and the reasons for these choices. Material and Methods: Purposive sampling, a pre-structured schedule, an observation approach, case studies, and interviews with community members have been used to gather the primary data used in the study. Result: The study identified a diverse pattern of health-seeking behavior. From the four villages, 70% of respondents combined into cluster-1 preferred the traditional healthcare system, mostly for geographical and cultural reasons, as opposed to 95% of respondents from the villages in cluster-2, who preferred modern healthcare services because they were more easily accessible and involved modern healthcare providers. Conclusion: In this research work, it has been found that the Juang tribe is in a transitional phase and uses a hybrid approach to health seeking. Moreover, it has also been discovered that important variables including cultural attitudes and the affordability of contemporary healthcare services have influenced people's decisions toward healthcare systems.

Small money, big change: The distributional impact of differentiated doctor's visit fee on healthcare utilization.

A prominent issue in China's healthcare sector is the overcrowding of high-tier hospitals, whereas low-tier hospitals and community health centers are severely underutilized. This study aims to examine whether doctor's visit fee and copay differentiated by the level of healthcare providers can change the distribution of outpatient visits across different levels of healthcare providers. By leveraging the exogeneity of the policy change implemented in a megacity in China in 2017, we apply a parametric discontinuity regression model to study the causal impact of differentiated pricing on patients' health-seeking behavior, using a large-scale insurance claim database. We find that the reform of differentiated doctor's visit fee schedule effectively increases the proportion of visits to primary care facilities among all outpatient visits. This effect is driven by a decline in visits to the highest-tier hospitals and an increase in visits to community healthcare centers. Furthermore, the policy effects are more pronounced among the elderly and people with chronic diseases. Our results suggest that shifting the focus of pricing policies from coinsurance to copays while continuing to improve the capacity of primary care facilities is an effective way to facilitate triaging patients into different levels of care without triggering moral hazard.