Research On Influence Of Behavioral And Mental Factors On Outpatient Service Use Among Weihai Residents

Research Background: There appears a complicated situation in China, that is the rate of patients without physician contact and self-treatment is increasing while the rate of outpatient use of medical department is reducing, which is resulted from the disagreement between the economic development of the society together with the increasing demand of health services and health services utilization. Outpatient department, a medical department mainly concerned with residents, is the beginning of a resident's healthcare and the main approach for residents to further healthcare. However, the residents 'behavior of outpatient seeking is a comprehensive result caused by many facts. According to the existing datum, the research in the past most does an analysis about the objective facts which affect the outpatient use(for example: the number, age and gender of people, the income and education of the family, the quality of the health services, the establishment and healthcare system etc), while rarely has a descriptive study on health services utilization from the angle of psychology and behavior. Therefore, it is necessarily for us to know about the effects on outpatient services use affected by behavior and mental factors to improve the health services utilization and better allocate the health resources.Objective: This study, through investigating the resident's behavioral and psychological condition and the situation of the inhabitant's outpatient service use, tries to find out the influence of behavioral and psychological factors on outpatient service use, and provides the basis of the reasonable allocation and the efficient use on the health resources for all health decision-making departments, so as to organize outpatient service scientifically.Methods: Stratum-based random sampling method was used to select samples. First we divided all the townships within each county and district of Weihai city into three categories based on the level of socio-economic development such as GDP per capita, composition of population with different education. From which we randomly selected one township from each category. Four medium size villages within each sampled township are randomly chosen. All the family members of each household lived in the chosen villages are interviewed by pre-trained data collectors. The survey covered 20395 persons. After data collection, the investigators will comb and code all the questionnaires. SPSS13.0 software package is used to analyze data. Firstly, it carries on descriptive analysis about the overall situation of resident's outpatient service use. Secondly, the single factor analysis (Chi-square Analysis) is used to check the relation between behavioral and psychological factors and the outpatient service use. Finally, the multi-factor analysis (logistic regression analysis) is used to analyze relative behavioral and psychological factors that may influence the outpatient service use.Results: The resident's prevalence rate within two weeks is 8.99 percent, the average rate of outpatient service seeking within two weeks 3.89 percent, the rate in rural areas is higher than that in urban areas; the patients select mainly the basic health service institution when they seek outpatient service; the crowd with good behavioral custom and life style, whose rate of outpatient service seeking within two weeks is lower; The crowd who have more social contact, whose rate of outpatient service seeking within two weeks is lower; the crowd with good psychological condition, its rate of outpatient service seeking within two weeks is lower; The result of logistic regression analysis showed that, the primary behavioral and psychological factors affecting utilization of outpatients are smoking situation, K10 score and hanving intimate friends or not.Conclusions: The influence of behavioral and psychological factors on outpatient service use exists obviously. The rate of outpatient service seeking within two weeks is different in persons who have different behavior and life style and mental health condition in the statistics. According to the results, and put forward the related suggestions: 1.On the allotment of health resources, enlarging at the allotment proportion of the health care and basic health service institution, particularly the community health service; 2.Developing health education and promotion actively;3.Enhancing and developing the community activities which are good for people's health; 4.Publicizing the mental health knowledge, and building up mental consultation and care system in the community, and improving the residents' mental state; 5.Adjusting the direction of health service, and the medical staff should participate in the prevention and control of disease, and extending the preventive scope, and turning the integrity health demand of a person to be the service object.