Help-Seeking Behavior, Use, and Satisfaction Among Frequent Primary Care Users in Santiago de Chile

Abstract

A survey of 140 low-income urban consumers of primary health care services provided by the public sector at Santiago Chiles Villa OHiggins Clinic suggested that organizational factors are more significant predictors of frequency of clinic use and patient satisfaction than demographic characteristics of the clinic population. 73% of respondents interviewed were female; the mean family size was 5 most were from families that fell well below the official poverty level and 76% of household income went toward food. 29% of the households represented lacked adult men or had unemployed male workers. 66% were acute care patients; the remainder were receiving treatment for chronic conditions such as diabetes high blood pressure and alcoholism. 70% had been attending the clinic for the past few years; the mean number of visits per year was 6.4. 53% indicated a preference for a public rather than a private doctor even if the latter were affordable. Only 51% expressed a dislike of any aspect of the clinic (long waits 24%; discourteous staff 19%; and lack of cleanliness 5%). 84% perceived the quality of the care they received as good; this perception was strongly associated with satisfaction with the physician and receipt of prescription drugs. Multiple regression analysis indicated that 4 organizational variables (travel time to clinic distance from home to clinic waiting time at clinic and travel time-travel distance) and 3 demographic factors (mother bringing child for care presence of children under 5 years of age and acute rather than chronic illness) were the best predictors of the frequency of clinic visits. Changes in clinic management by Chiles military government may jeopardize this pattern of high satisfaction with public health services by the poor.