Health seeking behavior and access to health care among patients with chronic cough diagnosed by county general hospitals in northern parts of Jiangsu province

Abstract

To analyze the impact of socioeconomic and demographic factors on health-seeking behavior among patients with long-term chronic cough. 310 patients with chronic cough, identified in two county general hospitals from the study sites were involved in a cross-sectional study. Questionnaire and personal interview were used for data collection. Binary logistic regression, Kaplan-Meier method and Cox analysis were applied in multivariate analysis to identify and quantify the impact of individual factors regarding the delay of reaching primary health care provider and the choice of health facility selection. Delay caused by patients themselves showed a difference between the counties with or without the programes. Occupation and medical insurance were associated with patients' health-seeking behavior. Patients under 18 years old had an earlier chance to access the health facility (RR = 1.90, 95% CI: 1.27 - 2.84), and choosing the general hospital as their first preference when seeking healthcare (RR = 2.06, 95% CI: 1.12 - 3.80). Patients with medical insurance were more likely to seek health care service in the general hospitals (RR = 1.64, 95% CI: 1.35 - 2.10). Only 2.5% of the patients with cough longer than two weeks had received sputum smear tests in the general hospitals. Occupation, medical insurance had great importance to the health seeking behaviors of patients with chronic cough which had not been viewed as an 'on-the-alert' symptom to be included in the tuberculosis control programs at the general hospitals either in the Programmed or Non-programmed counties in Jiangsu province.