Change in Utilization of Health Services and its Affecting Factors in Kayseri City Center: A Comparative Population-Based Cross-Sectional Study in 2004 and 2017 Kayseri İl Merkezinde Sağlık Hizmetleri Kullanımındaki Değişim ve Etkileyen Faktörler: 2004 ve 2017 Yılları Karşılaştırmalı Topluma Dayalı Kesitsel Çalışma

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Şenol V., Elmali F., ÇETİNKAYA F., NAÇAR M., Yalap R.

Turkiye Klinikleri Journal of Medical Sciences, vol.43, no.1, pp.49-63, 2023 (Scopus, TRDizin)

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 Cen-ters. 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 anal-ysis, 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 sig-nificantly 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, partic-ularly 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 un-derstanding of the factors that make access to the health facilities dif-ficult and the development of strategies that ensure fair use of health services.