Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Chronic Illness Pub Date : 2023-12-01 Epub Date: 2023-02-06 DOI:10.1177/17423953231153550

Sojib Bin Zaman, Roger G Evans, Clara K Chow, Rohina Joshi, Kavumpurathu R Thankappan, Brian Oldenburg, Ajay S Mahal, Kartik Kalyanram, Kamakshi Kartik, Michaela A Riddell, Oduru Suresh, Nihal Thomas, Gomathyamma K Mini, Pallab K Maulik, Velandai K Srikanth, Amanda G Thrift

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引用次数: 0

Abstract

Objectives: To assess the prevalence and determinants of cardiometabolic disease (CMD), and the factors associated with healthcare utilisation, among people with CMD.

Methods: Using a cross-sectional design, 11,657 participants were recruited from randomly selected villages in 3 regions located in Kerala and Andhra Pradesh from 2014 to 2016. Multivariable logistic regression was used to identify factors independently associated with CMD and healthcare utilisation (public or private).

Results: Thirty-four per cent (n = 3629) of participants reported having ≥1 CMD, including hypertension (21.6%), diabetes (11.6%), heart disease (5.0%) or chronic kidney disease (CKD) (1.6%). The prevalence of CMD was progressively greater in regions of greater socio-economic position (SEP), ranging from 19.1% to 40.9%. Among those with CMD 41% had sought any medical advice in the last month, with only 19% utilising public health facilities. Among people with CMD, those with health insurance utilised more healthcare (age-gender adjusted odds ratio (AOR) (95% confidence interval (CI)): 1.31 (1.13, 1.51)) as did those who reported accessing private rather than public health services (1.43 (1.23, 1.66)).

Discussion: The prevalence of CMD is high in these regions of rural India and is positively associated with indices of SEP. The utilisation of outpatient health services, particularly public services, among those with CMD is low.

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印度农村三个不同地区心脏代谢疾病患者的发病率和保健服务利用情况。

目的:评估心血管代谢疾病(CMD)的患病率和决定因素，以及与CMD患者的医疗保健利用相关的因素。方法:采用横断面设计，于2014 - 2016年在印度喀拉拉邦和安得拉邦3个地区随机抽取11657名参与者。使用多变量逻辑回归来确定与CMD和医疗保健利用(公共或私人)独立相关的因素。结果:34% (n = 3629)的参与者报告有≥1个CMD，包括高血压(21.6%)、糖尿病(11.6%)、心脏病(5.0%)或慢性肾脏疾病(CKD)(1.6%)。在社会经济地位较高的地区，CMD的患病率逐渐升高，从19.1%到40.9%不等。在患有CMD的人中，41%的人在上个月寻求过任何医疗建议，只有19%的人利用了公共卫生设施。在患有CMD的人中，那些有医疗保险的人使用更多的医疗保健(年龄-性别调整的优势比(AOR)(95%置信区间(CI)): 1.31(1.13, 1.51))，那些报告使用私人医疗服务而不是公共医疗服务的人(1.43(1.23,1.66))。讨论:在印度农村的这些地区，CMD的患病率很高，并且与SEP指数呈正相关。在CMD患者中，门诊医疗服务的利用率，特别是公共服务的利用率很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Illness Multiple-

CiteScore

3.80

自引率

0.00%

发文量

期刊介绍： Chronic illnesses are prolonged, do not resolve spontaneously, and are rarely completely cured. The most common are cardiovascular diseases (hypertension, coronary artery disease, stroke and heart failure), the arthritides, asthma and chronic obstructive pulmonary disease, diabetes and epilepsy. There is increasing evidence that mental illnesses such as depression are best understood as chronic health problems. HIV/AIDS has become a chronic condition in those countries where effective medication is available.