Health care utilization and its association with sociodemographic factors among slum‐dwellers with type 2 diabetes in Tabriz, Iran: A cross‐sectional study

Author:

Ghammari Fawzieh1ORCID,Jalilian Habib2ORCID,Khodayari‐zarnaq Rahim1,Gholizadeh Masumeh1

Affiliation:

1. Department of Health Policy and Management, School of Management and Medical Informatics Tabriz University of Medical Sciences Tabriz Iran

2. Department of Health Services Management, School of Health Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran

Abstract

AbstractBackground and AimsSlums are known as growing underprivileged areas. One of the health adverse effects of slum‐dwelling is health care underutilization. Management of type 2 diabetes mellitus (T2DM) requires an appropriate utilization. This study aimed to investigate the extent of health care utilization among slum‐dwellers with T2DM in Tabriz, Iran, in 2022.MethodsWe conducted a cross‐sectional study on 400 patients with T2DM living in slum areas of Tabriz, Iran. Sampling was conducted using a systematic random sampling method. A researcher‐made questionnaire was used for data collection. To develop the questionnaire, we used Iran's Package of Essential Noncommunicable (IraPEN) diseases, in which potential needs and essential health care for patients with diabetes and the appropriate time intervals for use are specified. Data were analyzed using SPSS version 22.ResultsAlthough 49.8% of patients needed outpatient services, only 38.3% were referred to health centers and utilized health services. The results of the binary logistic regression model showed that women (OR = 1.871, CI 1.170–2.993), those with higher income levels (OR = 1.984, CI 1.105–3.562), and those with diabetes complications (Adjusted OR = 1.7, CI 0.2–0.603) were almost 1.8 times more likely to utilize outpatient services. Additionally, those with diabetes complications (OR = 1.93, CI 0.189–2.031) and those taking oral medication (OR = 3.131, CI 1.825–5.369) were respectively 1.9 and 3.1 times more likely to utilize inpatient care services.ConclusionsOur study showed that, although slum‐dwellers with type 2 diabetes needed outpatient services, a small percentage were referred to health centers and utilized health services. Multispectral cooperation is necessary for improving the status quo. There is a need to take appropriate interventions to strengthen health care utilization among residents with T2DM living in slum sites. Also, insurance organizations should cover more health expenditures and provide a more comprehensive benefits package for these patients.

Funder

Tabriz University of Medical Sciences

Publisher

Wiley

Subject

General Medicine

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