Determinants of health care avoidance and avoidance reasons in Turkey

Sulku S. N. , Tokatlioglu Y., Cosar K.

Journal of Public Health (Germany), 2021 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2021
  • Doi Number: 10.1007/s10389-021-01577-z
  • Journal Name: Journal of Public Health (Germany)
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Psycinfo
  • Keywords: Avoiding medical care, Avoidance factors, Reasons for avoidance, Health care, I12, I18, SEEKING TREATMENT, MEDICAL-CARE, 1ST-EPISODE SCHIZOPHRENIA, UNTREATED PSYCHOSIS, BREAST-CANCER, DELAY, PEOPLE, DIAGNOSIS, RISK, DURATION
  • Ankara Haci Bayram Veli University Affiliated: No


© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Aim: This study aimed to identify predictors of avoiding or delaying seeking outpatient clinic level health care service and reasons for avoidance even though treatment is deemed necessary in Turkey. Subject and methods: Analysis of data on 12,032 participants aged 15 and older was carried out using 2012 Health Research Survey data. Univariate and multivariable logistic regression models were used to identify predictors of avoiding medical care. In addition, multivariable logistic regression models were used to identify reasons for this avoidance. Results: Compared to non-avoiders, the avoiders are more likely to be female. Being +45 age and being employed increases the probability of avoidance, but having SSI and higher income decreases the probability. Both feeling pain (odds ratio = 2.053, 95% confidence interval 1.735–2.429) and using non-prescription medications (odds ratio = 2.105, 95% confidence interval 1.823–2.430) increase the odds of avoidance. Having any-chronic disease, back musculoskeletal system disorders and mental diseases related to higher avoidance probability but cancer is opposite. Female, under 45 age, married, and using non-prescription medications participants are more likely to cite “high cost” and “not enough time” as a reason for avoidance. The reason “late appointment date” is significantly associated with rural and income level. Being +45 age is significantly associated with citing “fear” and being married is associated with the reason “nobody to accompany.” Conclusions: Understanding behaviors of avoiders and the factors of avoiding medical care are critical to reduce patient delay and avoidance to provide protection against irrevocable health consequences and financial burden.