背景:关于巴西亚马逊地区呼吸保健需求驱动因素的知识匮乏,在人类和身体保健资源差距很大的地方,在该地区西部进行了两次调查,在英亩州。潜在的驱动因素,通过对最近12篇论文的回顾,被分为七类捕获个体,家庭,社区和宏观经济层面。
方法:在2017年和2019年基于耦合的集团-配额随机抽样进行了定量实地调查。成年人对自己的健康或孩子的健康做出了回应。用多重非线性回归分析了最近一次呼吸道疾病或干咳的就医概率。将文献中的潜在预测因子作为协变量。
结果:儿童寻求医疗保健和购买药物的倾向更大。流感样疾病(尽管受访者表示确切的诊断为“流感”,病毒检测测试(如PCR测试)并不常用,根据英亩州公共卫生服务的通知。在一致性上,使用术语“流感样疾病”。)是最常见的诊断疾病,其次是肺炎,这表明,低于40%的医疗保健寻求率可能会使健康受损和局部传染长期存在。疾病严重程度,包括经历的疼痛,是主要的预测因子,揭示了主观感知比客观的个人和家庭特征更有影响力。
结论:结果表明,主观低估呼吸系统疾病对自身和当地社会的影响可能会阻止寻求医疗保健。这与以前的一些研究一致,但与强调客观因素作用的研究不同。社会后果,of,例如,宏观经济性质,需要根据检测医疗保健需求之间长期关系的研究来强调,在国家一级的健康和经济表现。取决于需求增加对卫生系统造成的成本与疾病生产力下降对经济造成的成本之间的权衡强度,可以采取政策,通过轻推以及教育和信息干预来改变对疾病的主观看法。
BACKGROUND: The scarce knowledge about the drivers of demand for respiratory health care in the Brazilian Amazon, where the gap of human and physical health care resources is wide, is expanded with two surveys conducted in the west of the region, in Acre state. Potential drivers, informed by a review of twelve recent papers, were classified into seven categories capturing the individual, household, community and macroeconomic dimensions.
METHODS: Quantitative field surveys were conducted in 2017 and 2019 based on coupled conglomerate-quota randomization sampling. Adults responded about their own health or their children\'s health. The probability of seeking physician care for the latest episode of respiratory illness or dry cough was analysed with multiple nonlinear regressions, having as covariates the potential predictors informed by the literature.
RESULTS: The propensity to seek health care and to purchase medication was larger for children. Influenza-like illness (Despite the exact diagnostic stated by respondents being \"influenza\", a virus detection test (such as the PCR test) is not commonly applied, as informed by the Acre state public health service. In consistency, the term \"influenza-like illness\" is used.) was the most frequently diagnosed disease, followed by pneumonia, suggesting that a health care-seeking rate below 40% may perpetuate health impairment and local contagion. Illnesses\' severity, including the pain experienced, was the main predictor, revealing that subjective perception was more influential than objective individual and household characteristics.
CONCLUSIONS: The results suggest that subjective underestimation of respiratory illnesses\' consequences for oneself and for local society could prevent health care from being sought. This is in line with some previous studies but departs from those emphasizing the role of objective factors. Social consequences, of, for instance, a macroeconomic nature, need to be highlighted based on studies detecting long-run relationships among health care demand, health and economic performance at the national level. Depending on the intensity of the trade-off between the costs imposed on the health system by increased demand and on the economy by the reduced productivity of the ill, policy could be adopted to change subjective perceptions of illnesses with nudges and educational and informational interventions.