Disparities in Physical Accessibility among Rural Thais Under Universal Health Coverage.


Journal

The American journal of tropical medicine and hygiene
ISSN: 1476-1645
Titre abrégé: Am J Trop Med Hyg
Pays: United States
ID NLM: 0370507

Informations de publication

Date de publication:
19 07 2021
Historique:
received: 24 12 2020
accepted: 26 04 2021
pubmed: 20 7 2021
medline: 12 10 2021
entrez: 19 7 2021
Statut: epublish

Résumé

This study aims to explore various barriers in accessing outpatient care among the participants from different age groups and to identify determinants associated with physician visits. The study had adopted Andersen's Behavioral Model (ABM) of Health Services Use. A cross-sectional study design was adopted to collect data from 417 participants through a questionnaire survey. Poisson regression models were used to explore determinants for explaining the differences in outpatient care use. The regression results revealed that divergent relationships existed among age groups. Children and elderly participants tended to decrease the probability of seeking care. Elderly participants confronted more difficulties in access and were dependent on family members. Despite free care provisions, participants visited and spent their out-of-pocket expenditure mostly at non-universal health coverage (non-UHC) facilities. Convenience and the availability of specialist physicians led the higher-income parents to seek care of their children at non-UHC facilities. Highly educated people of working age preferred more self-care or institutionalized care to save time. Children up to the primary level of education were more likely to visit a doctor. We concluded that investments in education or well-informed health services provision would improve health care utilization. Findings of Andersen's Behavioral Model variables suggested that improvements in the quality of services, medical professional skills, and efficient resource allocation may induce seeking care at UHC facilities. Consequently, it will reduce the number of referred cases, caseloads at tertiary care units, and visits to non-UHC facilities at longer distances.

Identifiants

pubmed: 34280131
doi: 10.4269/ajtmh.20-1627
pii: tpmd201627
pmc: PMC8592334
doi:
pii:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

837-845

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Auteurs

Rattanakarun Rojjananukulpong (R)

1Department of Development and Sustainability, Development Planning Management and Innovation, Asian Institute of Technology, Pathum Thani, Thailand.

Mokbul Morshed Ahmad (MM)

1Department of Development and Sustainability, Development Planning Management and Innovation, Asian Institute of Technology, Pathum Thani, Thailand.

Shahab E Saqib (SE)

2Higher Education, Archives and Libraries Department, Directorate of Commerce Education and Management Sciences, Khyber Pakhtunkhwa, Pakistan.

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