Decoding the drivers of healthcare utilization: The role of illness burden, lifestyle and household factors in rural North Karnataka, India

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI:10.1016/j.cegh.2026.102308

Sanjeev Chougule , Padmaja Walvekar , Annapurna Kari

{"title":"Decoding the drivers of healthcare utilization: The role of illness burden, lifestyle and household factors in rural North Karnataka, India","authors":"Sanjeev Chougule , Padmaja Walvekar , Annapurna Kari","doi":"10.1016/j.cegh.2026.102308","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Healthcare utilization in rural India remains uneven despite expansion of public health infrastructure. Identifying factors associated with healthcare-seeking is essential to strengthen service delivery. This study assessed the burden of illness and examined household, lifestyle, and health-related factors associated with healthcare utilization in rural North Karnataka.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional study was conducted among 1400 adults selected through a cluster-stratified sampling design. Healthcare utilization was defined as at least one visit to a formal healthcare facility within the preceding six months. Data were collected using a structured questionnaire. Multivariable logistic regression with cluster-adjusted robust standard errors was used to identify factors associated with healthcare utilization.</div></div><div><h3>Results</h3><div>Approximately two-thirds of participants reported healthcare utilization within the previous six months. In adjusted analyses, the presence of an elderly household member (AOR: 3.42; 95% CI: 2.15–5.43), hypertension (AOR: 2.18; 95% CI: 1.41–3.36), and diabetes mellitus (AOR: 1.61; 95% CI: 1.10–2.35) were independently associated with higher healthcare utilization. Ever use of tobacco was associated with lower utilization (AOR: 0.69; 95% CI: 0.50–0.96). Disability status was not independently associated after adjustment.</div></div><div><h3>Conclusion</h3><div>Healthcare utilization in rural North Karnataka was primarily associated with household context and chronic disease burden rather than individual demographic characteristics. These findings highlight population groups that may benefit from targeted health education, chronic disease management, and outreach services. Longitudinal studies are warranted to further examine causal pathways.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102308"},"PeriodicalIF":1.7000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Epidemiology and Global Health","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213398426000230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Healthcare utilization in rural India remains uneven despite expansion of public health infrastructure. Identifying factors associated with healthcare-seeking is essential to strengthen service delivery. This study assessed the burden of illness and examined household, lifestyle, and health-related factors associated with healthcare utilization in rural North Karnataka.

Methods

A community-based cross-sectional study was conducted among 1400 adults selected through a cluster-stratified sampling design. Healthcare utilization was defined as at least one visit to a formal healthcare facility within the preceding six months. Data were collected using a structured questionnaire. Multivariable logistic regression with cluster-adjusted robust standard errors was used to identify factors associated with healthcare utilization.

Results

Approximately two-thirds of participants reported healthcare utilization within the previous six months. In adjusted analyses, the presence of an elderly household member (AOR: 3.42; 95% CI: 2.15–5.43), hypertension (AOR: 2.18; 95% CI: 1.41–3.36), and diabetes mellitus (AOR: 1.61; 95% CI: 1.10–2.35) were independently associated with higher healthcare utilization. Ever use of tobacco was associated with lower utilization (AOR: 0.69; 95% CI: 0.50–0.96). Disability status was not independently associated after adjustment.

Conclusion

Healthcare utilization in rural North Karnataka was primarily associated with household context and chronic disease burden rather than individual demographic characteristics. These findings highlight population groups that may benefit from targeted health education, chronic disease management, and outreach services. Longitudinal studies are warranted to further examine causal pathways.

查看原文本刊更多论文

解读医疗保健利用的驱动因素：疾病负担、生活方式和家庭因素在印度北卡纳塔克邦农村的作用

背景：尽管印度扩大了公共卫生基础设施，但农村地区的医疗保健利用情况仍然不平衡。确定与求医有关的因素对于加强服务提供至关重要。本研究评估了北卡纳塔克邦农村地区的疾病负担，并检查了与医疗保健利用相关的家庭、生活方式和健康相关因素。方法采用整群分层抽样设计，对1400名成人进行社区横断面调查。医疗保健利用被定义为在过去六个月内至少到正规医疗机构就诊一次。使用结构化问卷收集数据。采用聚类校正稳健标准误差的多变量逻辑回归来确定与医疗保健利用相关的因素。结果大约三分之二的参与者报告在过去六个月内使用了医疗保健服务。在调整分析中，家庭中有老年人（AOR: 3.42; 95% CI: 2.15-5.43）、高血压（AOR: 2.18; 95% CI: 1.41-3.36）和糖尿病（AOR: 1.61; 95% CI: 1.10-2.35）与较高的医疗保健利用率独立相关。曾经使用烟草与较低的利用率相关（AOR: 0.69; 95% CI: 0.50-0.96）。调整后的残疾状态不独立相关。结论北卡纳塔克邦农村卫生保健利用主要与家庭背景和慢性病负担相关，而与个人人口统计学特征无关。这些发现强调了可能从有针对性的健康教育、慢性病管理和外展服务中受益的人群。纵向研究有必要进一步研究因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.