Disparities in Healthcare Utilization by Settlement Type in Serbia

Area of Science:

• Public Health
• Health Services Research
• Sociology of Health

Background:

• Urban-rural health disparities persist globally, reflecting differences in health outcomes, access to care, and socioeconomic status.
• Limited research in Serbia quantifies the influence of socio-demographic and economic factors on settlement type and healthcare utilization.

Purpose of the Study:

• To examine the relationship between settlement type (urban vs. rural) and socio-demographic/socio-economic factors in Serbia.
• To assess if these differences are reflected in healthcare utilization patterns.

Main Methods:

• Utilized data from the 2019 Serbian National Health Survey (n=12,439 adults).
• Employed descriptive statistics, Chi-square, t-tests, and logistic regression models.
• Calculated odds ratios (ORs) with 95% confidence intervals (CIs), with significance at p < 0.05.

Main Results:

• Higher education and being unmarried were associated with urban residence; lower education and middle-income status were linked to reduced urban living.
• No significant association found between settlement type and hospital or day hospital use.
• Rural residents showed lower prescribed medicine use, higher non-prescribed medicine use, and more frequent physiotherapy visits. Private practice use was significantly higher in urban areas.

Conclusions:

• Urban-rural disparities in Serbia are evident in medication use and healthcare seeking behaviors.
• Targeted strategies are needed, including enhancing rural health literacy, incentivizing rural physicians, expanding telemedicine, improving medication access, and integrating public-private healthcare.