Study on Medical Care-Seeking Behaviors and Chronic Comorbidities Based on the Ecology of the Medical Care Model

Abstract

Objective: To describe medical care-seeking behaviors using the ecology of the medical care model and analyze the association between comorbidities and various types of healthcare-seeking behaviors, providing theoretical evidence for the rational allocation of medical care resources. Methods: A cross-sectional survey was conducted among residents aged 20 and above from Fangshan District of Beijing and Wuyuan County of Jiangxi Province using multistage stratified sampling between July and September 2023. Descriptive analysis was performed based on the ecology of the medical care model, calculating medical care-seeking behaviors per 1,000 people per month and constructing a medical care ecology diagram. Multivariate logistic regression analysis was used to explore the relationship between comorbidities and medical care-seeking behaviors. Results: Valid questionnaires were collected from 6,004 participants (female: 56.4%, mean age 50.4 ± 14.7 years). Per 1,000 people per month, approximately 382 reported discomfort or injury, 162 visited medical institutions for outpatient care (61 visited primary care institutions, 47 visited tertiary hospitals), 62 self-medicated, 10 were hospitalized, five visited emergency departments, four underwent surgical procedures, and one received remote medical care. About 31.9% of participants reported having comorbidities, and their proportion of seeking medical care was higher than those without comorbidities or with single diseases. Multivariate logistic regression analysis showed that compared to individuals without chronic diseases, those with one chronic disease or multiple comorbidities had a higher likelihood of seeking medical care [(OR = 1.67, 95% CI: 1.38–2.02) and (OR = 3.40, 95% CI: 2.83–4.08)], and their likelihood of hospitalization was also higher [(OR = 2.60, 95% CI: 2.04–3.32) and (OR = 5.17, 95% CI: 4.10–6.51)]. Conclusion: Among the population with potential healthcare needs, less than half seek medical care, and those with chronic comorbidities have a higher proportion of seeking medical care. Research in the field of population medicine is needed to strengthen coordination and effective healthcare for people with comorbidities at various levels of institutions, thereby reducing unmet health needs.