Seeking, Delaying, and Avoiding Routine Health Care Services: Patient Perspectives
- 1 May 2014
- journal article
- research article
- Published by SAGE Publications in American Journal of Health Promotion
- Vol. 28 (5), 286-293
- https://doi.org/10.4278/ajhp.120702-qual-318
Abstract
Purpose. To explore/identify patient perspectives regarding seeking, delaying, and avoiding health care services, particularly barriers and facilitators. Design. Face-to-face interviews with health plan survey respondents. Setting. An integrated health plan providing comprehensive care to 480,000 people in Oregon and Washington. Participants. Willing respondents randomly selected to maximize heterogeneity within the following strata: gender, health care utilization, and self-reported alcohol consumption (indicator of health practices). Participants were 75 men and 75 women (150 total), 21 to 64 years old, with ≥ 12 months of health plan membership. Method. Participants were recruited by letter (52.5% agreed). Data collection stopped when planned interviews were completed; saturation (the point at which additional interviews were not producing novel information) was achieved for key study questions. Semi-structured interviews were recorded, transcribed, and coded. Reviews of codes related to care seeking and feelings/attitudes about providers produced common themes. Results. Facilitators of care seeking included welcoming staff, collaborative relationships with providers, and education about the value of preventive care. Barriers included costs, time needed for appointments, and cumbersome processes. Some participants delayed procedures, some avoided care until absolutely necessary, others framed care as routinely necessary. Conclusion. Increasing comfort, improving appointment and visit-related processes, having positive patient-physician relationships, and enhancing communication and clinician-provided education may facilitate appropriate use of preventive services. Further research is needed with larger, representative samples to evaluate findings.Keywords
This publication has 26 references indexed in Scilit:
- Receipt of Diabetes Preventive Care Among Safety Net Patients Associated with Differing Levels of Insurance CoverageThe Journal of the American Board of Family Medicine, 2012
- The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and ChallengesAnnals of Internal Medicine, 2010
- Principles of the Patient-Centered Medical Home and Preventive Services DeliveryAnnals of Family Medicine, 2010
- Drinking patterns, gender and health II: Predictors of preventive service useAddiction Research & Theory, 2010
- When a Usual Source of Care and Usual Provider Matter: Adult Prevention and Screening ServicesJournal of General Internal Medicine, 2008
- Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results.Psychiatric Rehabilitation Journal, 2008
- The Value and Practicality of Deliberate Sampling for Heterogeneity: A Critical Multiplist PerspectiveAmerican Journal of Evaluation, 1998
- Alcohol Use and Reported Physician Visits in Older AdultsPreventive Medicine, 1995
- Determinants of Children??s Health Care UseMedical Care, 1993
- On the Analysis of Ambulatory UtilizationMedical Care, 1979