Is Travel Time Associated with Health Service Utilization in Northwest China? Evidence from Shaanxi Province

Abstract

Purpose Northwest China has a large area, low population density, and few health resources, which makes the utilization of health resources in this region difficult. The objective of this study was to assess utilization of health services and its association with travel time in Shaanxi Province. Patients and Methods Data were obtained from the fifth Household Health Service Survey of Shaanxi Province conducted in 2013. Binary logistic regression was used to assess the relationship between travel time and health service utilization, and negative binomial regression was conducted to assess the relationship between travel time and the frequency of health service utilization. Results A total of 42.6% of patients used health services, with a higher use rate among rural residents than among urban residents (47.0% and 27.4%, respectively). A total of 30.9% of patients traveled more than 15 min to the nearest medical facility (33.3% in rural areas and 22.6% in urban areas). A total of 12.4% of patients traveled more than 30 min to the nearest medical facility (15.1% in rural areas and 3.0% in urban areas). Urban residents living farthest from health care facilities (more than 30 min) had a 2.12-fold higher probability of health service utilization and expected to have a health service utilization rate 1.77 times greater than that of residents with a travel time of less than 5 min. Among the rural population, there was no significant correlation between travel time and health service utilization. Conclusion Urban patients living farthest from hospitals were more likely to use health services and used health services more frequently. This suggests that more attention should be given to urban patients who live far away from health service providers in Shaanxi Province.

Uptake of Preventive Nutrition Interventions among Caretakers of Children under 5 years in a pastoral setting of South Sudan

“…Poor physical access to health facilities was identified as a key contributor to reduced uptake of preventive health services [25]. The current finding on time to health facility doesn't conform to a study done in China which found no correlation between travel time, utilization and uptake among rural residents in Shaanxi Province [26] owed to different contexts of pastoral context in the current study. Very few studies have been conducted in pastoral settings and perhaps limited data to support these results but confirms the need for future investigations using other multilevel approaches [27].…”