How does residents’ experiences with community health service affect their utilization wishes? A population-based survey in China

Abstract

Objectives: Although the number of community health services (CHS) agencies in China has increased rapidly, they are not well used by residents. The aim of this study was to explore residents’ experiences of CHS and their effects on residents’ utilization wishes.Methods: We conducted a cross-sectional door-to-door survey in Wuhan City, in central China. Five indicators (use convenience, environment, attitudes, degree of seriousness and medical costs) were selected as independent variables to reflect residents’ experiences of CHS. Control variables included age, gender, marital status, education level, self-perceived economic status, duration of residence, doctor-diagnosed hypertension and health insurance.Results: Among the five indexes of experiences, the results were as follows: use convenience (91.96%), attitudes (82.12%), degree of seriousness (79.53%), environment (71.94%) and medical costs (60.33%). After adjusting for the potential confounding variables, environment, degree of seriousness and medical costs were the most meaningful influences on residents’ utilization wishes (OR: 2.11, 95% CI: 1.11-4; OR: 2.19, 95% CI: 1.03-4.64; OR: 2.71, 95% CI: 1.46-5.03, respectively).Conclusion: The effects of degree of seriousness and medical costs appear to indicate that residents’ use of CHS is rational. However, the effect of environment may reveal that residents’ use of CHS is partly perceptual (‘judging a book by its cover’). The sustainable development of CHS should take account of these factors.