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Published on: October 24, 2019
Determinants of healthcare-seeking behavior from pharmacies and associated out-of-pocket spending: a population-based
Rasha M Arabyat1,2, Eman A Hammad1,3, Samah Al-Shatnawi4
1Department of Health Economics and Healthcare Administration, Public Health Institute, University of Jordan, Amman, Jordan.
Objectives:
To identify determinants of healthcare seeking from pharmacies in Jordan using Andersen's healthcare utilization model. Additionally, an analysis of the out-of-pocket (OOP) spending was performed.
Methods:
An analysis of the Jordan Population and Family Health Survey (JPFHS), a nationally representative survey of Jordanian households, was conducted. Weighted hierarchical multiple logistic regression models were built to specify important variables related to seeking care from pharmacies in Jordan compared to other outpatient healthcare facilities.
Key Findings:
Out of 12,716 respondents, 19.1% reported visiting a pharmacy within the past 4 weeks. The associated average OOP spending was JD17.7, significantly lower than for other outpatient healthcare facilities (JD 24.8). Among predisposing characteristics, females were more inclined to visit a pharmacy compared to males (adjusted odds ratio [AOR] = 1.16; 95% CI: 1.02-1.33). Positive enabling factor included residing in northern (AOR: 1.85; 95% CI: 1.19-2.87) or southern regions (AOR: 3.66; 95% CI: 1.57-8.56) compared to center regions of Jordan. The cost of transportation was a negative enabling factor (AOR: 0.24; 95% CI: 0.15-0.40). Significant need factors that increased the odds of visiting a pharmacy included seeking care for fever/diarrhea (AOR: 1.99; 95% CI: 1.04-3.80). Preventive care/vaccination (AOR: 0.18; 95% CI: 0.05-0.68) decreased the odds of visiting a pharmacy.
Conclusion:
The geographical location of a pharmacy, as indicated by transportation costs and region, significantly influences visiting patterns. Pharmacies appeared to be convenient and accessible for managing minor ailments and they offer significant potential for cost savings. To enhance pharmacies' contribution to public health, the integration of new services is strongly recommended.
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