The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67215

Masood A. Shaikh, MD, MPH¹, Irshad A. Shaikh, MD, MPH, PhD¹, and Greg Pappas, MD, PhD². (1) Chester Health Bureau, Department of Public Safety, Chester City Hall, One 4th Street, Chester, PA 19013, (610) 447-7824, masoodali1@yahoo.com, (2) Demographic and Health Surveys (Measure DHS +), MACRO International Inc., 11785 Beltsville Drive, Calverton, MD 20705

This study estimates the prevalence and profile of people (21 – 70 year olds) seeking medical care in the past two weeks in Pakistan, by examining its relationship using logistic regression with gender, economic status, age, and residential status in terms of urban/rural, using the data from the National Health Survey of Pakistan (NHSP), 1990-94. A two-stage stratified sample design was adopted for NHSP. The survey population comprised of 7850 individuals aged 21 – 70 years. STATA 7 was used to conduct a design-based analysis. Individuals who responded affirmatively to the question “During the past 14 days have you sought medical care?” were defined as having sought medical care. Individuals who sought any type of care including traditional were asked this question. The overall prevalence of medical care seekers in the past two weeks was 24.5% and 95% Confidence Interval (CI) was 22.2% – 26.8%. Odds Ratios (OR) were computed for the association of having sought medical care with various demographic variables. Medical care seekers were more likely to be in the middle economic status (OR 1.47, 95% CI 1.21 – 1.78), compared to the ones in low economic status, while no statistically significant association was found with high economic status. Men were less likely to seek medical care in the past two weeks, compared to women (OR 0.75, 95% CI 0.63 – 0.89). Age was assessed in five, ten year groups i.e. 21 – 30, 31 – 40, 41 – 50, 51 – 60, and 61 – 70. Compared to 21 – 30 year age group, statistically significant association was observed in 41 – 50 year olds (OR 1.27, 95% CI 1.03 – 1.56), and 61 – 70 year age group (OR 1.28, 95% CI 1.0 – 1.62). No significant association was found with urban/rural residency status. Among all the individuals who sought medical care, the proportion of individuals who, as a first choice went to see a government doctor i.e. in city/state funded hospitals was 0.22, with the standard error (SE) of 0.026. Private physicians, as a first choice accounted for a proportion of 0.48 (SE 0.028). While the proportion of Paramedics as a first choice for seeking medical care was 0.20 (SE 0.020). Results demonstrate that an overwhelmingly majority of individuals seeking medical care, whether urban or rural dwellers, preferred modern/western medicine model of care.

Learning Objectives:

• Describe the socio-demographic variables that affect seeking of medical care in Pakistan
• Assess the preferences for public sector versus private sector in a developing country setting

Keywords: Developing Countries, Epidemiology

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The survey results presented in this abstract was done by the Pakistan Medical Research Council.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.