A Comprehensive Examination of Poverty, Health-Seeking Behavior, and Access to Health Services With a Mixed-Methods...

The complex relationship between poverty, health-seeking behavior, and access to health services is critical to understanding health inequalities. This study aimed to deepen our understanding of this field by examining the relationships between poverty, health-seeking behavior, and access to health services with a mixed-methods approach.

Between December 2023 and March 2024, a mixed-methods design (QUAN-QUAL) was employed using a convergent (sequential) approach. The quantitative phase adopted a cross-sectional research approach, while the qualitative part embraced a phenomenological approach. The quantitative stage involved 384 participants, and the qualitative stage involved 11 individuals. Quantitative data were collected using the Health Seeking Behavior Scale and the Healthcare Demand Procrastination Scale. In contrast, qualitative data were gathered through in-depth individual interviews using a semi-structured interview guide.

As household income levels increase, health-seeking behavior (r = 0.141, p < 0.001) and healthcare demand procrastination (r = 0.143, p < 0.001; β = 0.132, p = 0.003) significantly increase. Health-seeking behavior rises among individuals who perceive their general health status as good (F = 7.111, p < 0.001; β = 0.143, p = 0.004). In contrast, low income levels (t = 3.797, p < 0.001; β = -0.147, p = 0.004) and low education levels (F = 4.791, p < 0.001; β = -0.145, p = 0.004) are significantly associated with decreases in health-seeking behavior. Procrastination of healthcare demand is more common among workers (β = 0.176, p < 0.001). On the other hand, higher income levels and the distribution of health expenditures appear to reduce this tendency (β = -0.121, p = 0.015; β = -0.116, p = 0.021). The synthesis of interviews revealed two main themes: utilization of health services, and access to health services and inequalities. Within the theme of "challenges in accessing health services," the qualitative thematic analysis highlighted key difficulties such as transportation problems, long waiting times, and insufficient personnel.

Findings indicate that socioeconomic factors such as income level and education were determinants of health-seeking behavior and that healthcare demands procrastination behavior. Among the challenges encountered in accessing health services, transportation issues, long waiting times, and inadequate staff were prominent.