Health care provider preferences among the adults residing in a rural area of the Kurunegala district

Abstract

The objective of this study was to identify where people go for initial treatment and the reasons for preferring one type of healthcare sector over the other. A descriptive cross-sectional study was carried out in April 2011 by using an interviewer-administered questionnaire. Written consent was obtained from the chief householder and ethical clearance was obtained from the Ethical review committee of the Faculty of Allied Health Sciences.

Hundred families were selected using simple random sampling in Meddegama - West Grama Sewaka division, Kurunegala district. Respondents were asked to prioritise a given set of reasons for choosing a specific healthcare sector on a scale of 1-6. Preference was calculated by applying unpaired t-tests with regard to the relevant variables.

The preferred first contact health care was private care providers (64%). Reasons for choosing the private sector were given as: first priority - fewer difficulties or being user friendly (P =0.001, CI = 1.79 to 2.83) second - short distance (P = 0.001, CI = 0.37 to 1.37), third - good relationship/ better rapport (P =0.000, CI = 0.70 t01.54) and fourth - high availability (P = 0.052, CI = -0.01 to 0.90). Low cost (P =0.000, CI = -3.47 to - 2.68) and safety and confidence (P =0.000, CI = -2.26 to -1.08) were reasons for choosinq the government sector.

The subjects preferred the private sector for trivial ailments such as gastrointestinal and respiratory diseases while choosing the government health sector for more serious illnesses such as cardiovascular and nervous system illnesses, mental illness and snake bites as they had greater confidence in the safety of the government sector.

Chief householders with formal education of ten years and above who comprised 85% of the study population chose private healthcare providers (70.6%). Social class 1 was not represented in the study population. Those belonging to social class 2, 3 and 5 preferred the private sector (75%, 76.9% and 69.6% respectively) while social class 4 preferred the government sector (51.9%). Although government health care is free, even the poor preferred the private sector due to convenience and better rapport with the healthcare provider. However, the government sector has won the confidence of the people as being safer for serious illnesses.