Study On Medical Seeking Behavior To Primary Health Care Institutions And Influence Factors Among Children Based On Anderson’s Behavioral Model Of Health Services Use

Research PurposeUnder the background of actively promoting the construction of hierarchical diagnosis and treatment system,the health service capacity of primary health care institutions for children has weakened and the problem of children’s higher medical treatment is prominent in China.This study analyzed the characteristics of children’s medical seeking behavior to primary health care institutions by conducting a questionnaire survey on children in Guangzhou,and performed confirmatory analysis by using structural equation model for analysis of the action mechanism among influence factors,in order to put forward some suggestions and provide empirical basis for a scientific and orderly pattern of pediatric medical treatment.Research MethodIn this study,the parents of children who were aged 0 to 14 years old inGuangzhou were investigated after a self-made questionnaire was set up based on the Anderson’s behavioral model of health services use.Data were collected online and offline.The online survey adopted convenient sampling,and the questionnaire were sent to the children’s parents by researchers through WeChat App.Convenient sampling and random sampling were used for offline research.Two general hospitals,three community health service centers and other public places,such as children’s parks,were selected for offline research in Baiyun District,Haizhu District and Liwan District in Guangzhou.A total of 600 questionnaires were collected and 501 were valid.The effective rate of the questionnaire was 83.5%.This study used SPSS 26.0 for descriptive analysis of medical seeking behavior to primary health care institutions among children in Guangzhou.The measurement data were described by χ±s,and chi-square test was used for comparison between groups.SPSS Amos 24.0 was also used to construct the structural equation model of influencing factors of medical seeking behavior to primary health care institutions among children in Guangzhou.The level of significance was 0.05.Research Results1.Among the 501 children surveyed in Guangzhou,boys accounted for 57.9%and girls accounted for 42.1%.The average age of the children interviewed in Guangzhou was(4.95±4.05)years.The children interviewed were mainly urban children(85.2%),and rural children accounted for 14.8%.The signing rate of family doctor service contracts among the children was 22.4%in this study.2.36.5%of the children were willing to turn to primary health care institutions for medical service in Guangzhou.3.70.86%of the children surveyed in Guangzhou preferred to chose large hospitals when suffering from common diseases.Closer distance and abundant pediatric medical resources were the main reasons for taking large hospitals into first consideration.Proportion of urban children’s first choice of large hospitals was higher than that of rural children.Significant difference existed in the first choice of medical institutions for children with common diseases in different regions(P=0.004).4.The scale was of good reliability and validity,and the cumulative contribution rate of variance was 71.9%.This study established a theoretical model of the action mechanism of the influence factors of children’s medical seeking behavior to primary health care institutions,that is,medical seeking behavior was influenced by contextual characteristics,personal characteristics,health outcomes and service accessibility,health outcomes had a one-way effect on contextual characteristics,and situational characteristics had a one-way effect on service accessibility.5.The structural equation model of influence factors of medical seeking behavior to primary health care institutions among children in Guangzhou revealed that the direct path relationship between personal characteristics and service accessibility on health behavior were all not statistically significant.The total effect of health outcomes on the standardization of health behavior was 0.733,while the total effect of contextual characteristics on the standardization of health behavior was 0.184.Research Conclusions1.The signing rate of family doctor service contracts among the children in Guangzhou had not reached the expected policy target of 60%in this study.2.The willingness for primary health care institutions among children in Guangzhou was low,because the willingness of children to seek medical services at primary health care institutions was 36.5%.3.70.9%of the children in Guangzhou preferred to higher level hospitals for treatment when suffering from common diseases in this study.The main reasons for choosing higher level hospitals were closer distance and abundant pediatric medical resources.The proportion of urban children who preferred to go to higher level hospitals was higher than that of rural children.There were significant differences between urban and rural children in the distance from their residence to different levels of medical institutions and intended medical institutions for common diseases in Guangzhou(P<0.05).4.Health outcomes in primary health care institutions had an important impact on children’s medical seeking behavior to primary health care institutions.Therefore,improving the medical experience of children in primary health care institutions,especially improving the overall satisfaction of health services in primary health care institutions,would help to promote children’s medical seeking behavior to primary health care institutions.