Aims: To determine self-health image and illness perception as potential barriers to health services access among inhabitants of La Plata, Buenos Aires, Argentina. Methods: A cross-sectional study, where survey, "Brief Illness-Perception Questionnaire" and basic medical examination were performed on 2430 participants at homes. Results: Although men showed a better concept of their state of health, they perceived their illness worse and belatedly. Only 45% of participants perceived symptoms disease, and from them, 48% finally decided to consult to the health system. Hence, from every 100 sick people, only 21 had access to a health institution. Higher level of education achieved, better socio-economic conditions or holding health insurance were significantly associated with appropriate health seeking, and access to health service. Conclusions: Self-health image and disease perception affected people's access to health services. Participants of this study showed suboptimal disease perception, manifested as meager and delayed demand for care. These results demonstrate the weakness of current health care model based on people's spontaneous demand. It is necessary to adopt a new health system for the entire population, regardless of the self-awareness that people may have about their own health/disease status. It would be a more inclusive, effective and efficient healthcare model.
Background. Knowing how health problems are perceived is an element of primary importance for health systems, since it is the first step for the population to recognize a disease and demand medical attention. Objectives. To develop and evaluate the implementation of a new healthcare model adapted to the necessities and illness self-perception of a community in the urban area of greater la Plata, Buenos aires, argentina. Material and methods. The community's self-rated general health status and illness self-perception were explored by a survey, followed by an intervention study performed on 2,430 participants randomly divided in 2 groups (Intervention: received personalized home health care; Control: health care was provided from hospitals and primary care health services). Results. almost 70% of the participants were satisfied with their health status. In cases where a disease was detected; older people and men shown to perceive their illness later compared to women and young adults. Only 21% of the population had suitable access to a health service. Compared with the Control group, regular and personalized home visits significantly improved treatment adherence (43% vs 94%), reduced annual undesirable events (stroke, myocardial infarcts, etc.) associated to chronic diseases (2.7% vs 1.2%) and lowered hospitalization rates (2.9% vs 2.0%). Conclusions. The data obtained showed that the population had low illness awareness, which reduced the spontaneous demand of care in health services. a model of health care based on regular home visits demonstrated efficacy in terms of disease prevention, illness control, avoiding consequences of chronic disease and reducing hospitalizations.
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