Healthcare Utilization for Noncommunicable Disease Management among Adults in a Rural South Indian Community: A...

Several factors influence people's decisions about the choice of healthcare provider. This study was planned to identify determinant factors beyond accessibility, that influence the utilization of healthcare services for Noncommunicable Disease (NCD) management.

A community-based cross-sectional study was conducted among adults diagnosed with NCDs in the villages of Dakshina Kannada, the southernmost district of Karnataka, India. Each of these villages has access to both public or private primary, secondary, and tertiary healthcare services. The sample size, determined to be 700, was calculated utilizing the prevalence of healthcare utilization for NCD management, reported in a study done in a neighboring district. Following the implementation of the multistage cluster sampling method, 10 villages were selected as clusters. The line list of the households from each cluster was prepared with the help of health workers. The first household from a cluster was selected utilizing a simple random sampling method. Subsequent households were taken by moving in one direction (right) of the houses till the sample size reached 70 from a single cluster. A semistructured questionnaire, validated by experts and informed by research objectives and a thorough review of the literature, was used for data collection.

All the participants were utilizing healthcare services for the management of NCDs. Within our study population, the majority (N = 523,74.7%) reported a single NCD. A proportion of study participants (N = 516,73.7%) opted for private healthcare services, while the primary health center (N = 179,25.6%) was the major service provider in the public sector. Socioeconomic background, religion, duration of disease, and proximity to health facilities were identified as significant predictors of public healthcare utilization. Compared to participants with a disease duration exceeding 10 years, those with less than 5 years or 5 to 10 years of duration had significantly higher adjusted odds ratios (aOR (adjusted odds ratio) = 2.453, CI (confidence interval) = 1.316-4.572 and aOR = 1.161, CI = 1.083-2.415, respectively) for utilizing government health services. Additionally, participants residing within a distance of less than 5 km from healthcare facilities exhibited substantially greater odds (aOR = 7.213, CI = 3.732-13.940) of utilizing government health services compared to those living over 10 km away. These findings suggest that shorter disease duration and closer proximity to healthcare facilities are associated with increased utilization of government health services among participants.

This study highlights the key determinants influencing healthcare utilization among individuals with NCDs in the study area. Socioeconomic status, disease duration, religion, and distance to healthcare facilities were significant predictors of public health service utilization. While physical proximity plays an important role, other sociodemographic and disease-related factors also contribute substantially to healthcare-seeking behavior. These findings provide useful insights for policymakers aiming to strengthen NCD management within the public health system.