| Objective:To understand the current status of healthcare seeking behaviors of patients with chronic obstructive pulmonary disease(COPD),explore the causes of different healthcare seeking behaviors.We analyzed the influencing factors of healthcare seeking behaviors for patients with COPD,and provided advice and reference for guiding COPD patients to seek medical treatment in the next step.Methods:A two-stage sampling was used to select 321 patients with COPD who were hospitalized in various levels of hospitals in Suzhou from December 2018 to December 2019 as the research object for cross-sectional investigation.Based on the survey results,the status of healthcare seeking behaviors of COPD patients was described,and the reasons and influencing factors for choosing the timing of medical treatment and medical institution level were analyzed.Results:1.Timing of COPD patients' healthcare seeking behavior and its influencing factors.(1)Timing of consultationIn this study,the delay rate of COPD patients was 47.7%,the delay time was 1?730 days,the average delay time was(17.51±45.73)days,and the median of delay time was 7(3,14)days.Among them,37.9%of patients had delayed healthcare seeking behavior for more than 1 month,and 9.2%of patients had delayed healthcare seeking behavior for more than 3 months,the longest delay in seeking treatment was more than 24 months.(2)Reasons for healthcare seeking behavior timeThe most common reason for COPD patients to delay healthcare seeking behavior was that they thought the condition was not serious,accounting for 40.5%;the symptoms were relieved after self-treatment,accounting for 36.6%;economic reasons and inconvenience account for 11.8%and 5.9%,respectively.(3)Analysis of factors affecting the time of consultationMultivariate analysis showed that residence,disease management attitudes,family support,number of admissions due to acute exacerbation in the past year,and health self-evaluation levels were factors that affected the duration of COPD patient visits.2.Choice of medical institutions for COPD patients and influencing factors.(1)Analysis of reasons for choosing different medical institutionsThe source of COPD patients in this study was 121 cases(37.7%)in tertiary medical institution,100 cases(31.2%)in secondary medical institution and 100 cases(31.2%)in primary medical institution.The reasons for COPD patients chose a primary medical institution were:close to home(86.0%),convenient transportation(68.0%),reasonable fees(60.0%),etc.The reasons for choosing a secondary medical institution were:close to home(57.0%),convenient transportation(48.0%),trusted doctor(48.0%),etc.The reasons for choosing a tertiary medical institution were:high level of hospital technology(77.6%),trusted doctors(62.0%),complete hardware facilities(48.8%),etc.COPD patients were reluctant to choose a primary medical institution because they believed that the technical level was low(37.4%),medicines were low(36.6%),etc.(2)Analysis of factors influencing the choice of medical institutionsTaking the primary medical institution as a control,the analysis results of disordered multi-class logistic regression equation showed that age,education,marital status,occupation,living status,disease awareness,mMRC grade,and self-assessed disease severity were the influencing factors of patients to choice primary or secondary medical institution(P<0.05).Age,marital status,occupation,medical insurance,number of admissions due to acute exacerbation in the past year and mMRC grade were the influencing factors of patients to choose primary or tertiary medical institution(P<0.05).Taking the secondary medical institution as a control,educational level,living conditions,disease awareness,self-assessed disease severity,and number of admissions due to acute exacerbation in the past year were the influencing factors of patients to choose secondary or tertiary medical institution(P<0.05).Conclusions:1.The delayed incidence of COPD patients in Suzhou was 47.7%.The reasons for the delay in healthcare seeking behavior were that the patients thought it was not serious,the symptoms were relieved after self-treatment,economic reasons and inconvenience.Factors affecting patients' delay in healthcare seeking behavior included residence,attitudes to disease management,family support,number of admissions due to acute exacerbation in the past year and health self-evaluation levels.2.The reasons for COPD patients in Suzhou to choose a primary medical institution were close to home,convenient transportation,and reasonable fees.The reasons for choosing a secondary medical institution were close to home,convenient transportation,and trusted doctors.The reasons for choosing a tertiary medical institution were high technical level,trusted doctors and complete hardware facilities.The reasons for not willing to choose a primary medical institution for healthcare seeking behavior were mainly that the technical level of the primary medical institution was low,the medicines were few,and the hardware facilities were poor.3.When the primary medical institution was taken as a reference,factors affecting the choice of primary or secondary medical institutions for COPD patients were age,education,marital status,occupation,living status,disease awareness,mMRC grade and self-assessed disease severity.Factors affecting the choice of primary or tertiary medical institutions for patients were age,marital status,occupation,medical insurance,number of admissions due to acute exacerbation in the past year and mMRC grade.When the secondary medical institution was taken as a reference,factors affecting the choice of secondary or tertiary medical institutions for patients were education,living conditions,disease awareness,self-assessed disease severity and the number of admissions due to acute exacerbation in the hospital in the past year. |
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