Analysis of Healthcare Seeking Behavior Among Patients Visiting Public Primary and Secondary Healthcare Facilities in an Urban Indian District

In this work, we examined healthcare seeking behavior (HSB) of patients visiting public healthcare facilities in an urban context. We conducted a cross-sectional survey across twenty-two primary and secondary public healthcare facilities in the South-west Delhi district in India. The survey was designed to ascertain from patients at these facilities their HSB - i.e., on what basis patients decide the type of healthcare facility to visit, or which type of medical practitioner to consult. From each facility visited, we also collected operational information, such as the average number of patients visiting per day, and the medical services provided at each facility. Based on participant responses, we observed that factors such as wait time, prior experience with care providers, distance from the facility, and also socioeconomic and demographic factors such as annual income, educational qualification, and gender significantly influenced preferences of patients in choosing healthcare facilities. We used binomial and multinomial logistic regression to determine associations between HSB and socioeconomic and demographic attributes of patients at a 0.05 level of significance. Our statistical analyses revealed that patients in the lower income group preferred to seek treatment from public healthcare facilities (OR = 3.51, 95% CI = (1.65, 7.46)) irrespective of the perceived severity of their illness, while patients in the higher income group favored directly consulting specialized doctors (OR = 2.71, 95% CI = (1.34, 5.51)). Other factors such as having more than two children increased probability of seeking care from public facilities. This work contributes to the literature by providing quantitative evidence regarding overall patient HSB, especially at primary and secondary public healthcare facilities, regardless of their presenting illness, and operational information regarding healthcare delivery at these facilities. This work can inform policy designed to improve accessibility and quality of care at public primary and secondary healthcare facilities in India.