Kayseri İl Merkezinde Sağlık Hizmetleri Kullanımındaki Değişim ve Etkileyen Faktörler: 2004 ve 2017 Yılları Karşılaştırmalı Topluma Dayalı Kesitsel Çalışma

Abstract

Objective: This study aimed to examine the change in health service use and its affecting factors by comparing the findings of 2 studies conducted at different times, with the same data collection tools, in the same health service region. Material and Methods: The first cross-sectional study was conducted in 2004, in urban areas in Kayseri, with 501 households and 1,880 people in Primary Health Centers. The second was carried out in 2017, in 30 Family Health Centers, with 801 households and 2,253 people. The data were collected by the face-to-face interview method using a questionnaire. In statistical analysis, mean±standard deviation, median (Q1-Q3), Mann-Whitney U, Kruskal-Wallis, Pearson χ2 , logistic regression analysis were used. The value p <0.05 was accepted as statistically significant. Results: The rate of health service utilization (HSU) increased from 79.6% to 84.8%, the average number of visits to physicians per person increased from 4.9 to 6.9. While the proportion of primary HSU increased to 45.8%, requests for visits to public hospital decreased to 26.4%. Healthcare use was significantly higher in male gender (2.2-2.3 times), 65 years and older (2.8-3.2 times), in people with good income (1.8-1.5 times), and in those with negative health perception (1.8-1.9 times). Conclusion: There has been a significant improvement in HSU parameters, particularly in Primary Health Care Centers services. Male gender, good level income, advanced age (≥65), and negative health perception are the main determinants of healthcare use. These results require a better understanding of the factors that make access to the health facilities difficult and the development of strategies that ensure fair use of health services.