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This study applied the ecology of the medical care model to describe healthcare-seeking behaviors among community-based individuals and to examine the association between multimorbidity and various types of healthcare-seeking behaviors.
A cross-sectional survey was conducted in Fangshan District, Beijing and Wuyuan County, Jiangxi Province from July to September 2023. Community residents aged 20 years old and above were sampled by using a multistage stratified sampling approach and recruited to participate in the study. The number of individuals who had symptoms or had relevant healthcare-seeking behaviors was calculated per thousand people per month and relevant indicators were demonstrated by using the ecology of the healthcare model. Multivariate logistic regression analyses were applied to explore the association between self-reported multimorbidity and each level of healthcare-seeking behaviors, with key socio-demographic characteristics adjusted in the model.
A total of 6 004 records with completed surveys were included in the analysis (56.4% of participants were females, mean age: 50.4±14.7). On a thousand-person per month basis, about 382 participants self-report having symptoms, 162 had visited to healthcare facilities (including 61 visited to primary healthcare facilities, 47 visited to tertiary hospitals), 62 were self-medicated, 10 were hospitalized, 5 visited to emergency department, 4 had operations and 1 received tele-medicine. A higher proportion of healthcare seeking behaviors were observed among individuals with multimorbidity than those self-reported with no or one chronic condition. The results of multivariate logistic regression analyses showed that compared with individuals without chronic condition, individuals with one chronic condition or multimorbidity had higher likelihood of healthcare facility visits [(OR:1.67, 95% CI:1.38-2.02) and (OR:3.40, 95% CI:2.83-4.08)], and hospitalization [(OR:2.60, 95% CI:2.04-3.32) and (OR:5.17, 95% CI:4.10-6.51)].
Among all individuals with potential healthcare needs, less than half had healthcare seeking behaviors, and the proportion is higher among individuals with multimorbidity. Future research should further investigate the implication of findings on population medicine from the ecology of medical care model. Actions are also needed to further strengthen the healthcare system and optimize its integration and effectiveness in addressing the emerging challenge of multimorbidity and to reduce the unmet health needs.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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