Factors affecting healthcare users’ first contact with PHC facilities in Jilin, China, 2008–2018, by urban and rural settings
| Factors | Urban | Rural | ||||
| First contacting PHC facilities, % | Crude RR (95% CI) | Adjusted RR (95% CI)† | First contacting PHC facilities, % | Crude RR (95% CI) | Adjusted RR (95% CI)† | |
| Year | ||||||
| 2008 | 36.18 | 0.61 (0.39 to 0.95)** | 0.77 (0.56 to 1.07) | 75.45 | 0.87 (0.77 to 1.00)* | 0.96 (0.85 to 1.09) |
| 2013 | 62.29 | ref | ref | 84.01 | ref | ref |
| 2018 | 42.49 | 0.67 (0.49 to 0.91)** | 0.78 (0.60 to 0.99)* | 71.21 | 0.83 (0.75 to 0.92)** | 0.89 (0.80 to 0.98)* |
| Type of diseases | ||||||
| Diseases recommended to PHC facilities | ||||||
| Hypertensions and/or diabetes | 62.40 | 1.86 (1.57 to 2.21)** | 1.67 (1.39 to 2.00)** | 86.80 | 1.42 (1.33 to 1.51)** | 1.39 (1.30 to 1.48)** |
| Acute upper respiratory tract infections | 74.45 | 2.22 (1.87 to 2.64)** | 2.11 (1.76 to 2.53)** | 92.25 | 1.51 (1.41 to 1.61)** | 1.50 (1.41 to 1.60)** |
| Other ailments | 38.32 | 1.14 (0.93 to 1.41) | 1.11 (0.90 to 1.36) | 72.65 | 1.19 (1.10 to 1.28)** | 1.17 (1.09 to 1.26)** |
| Diseases not recommended to PHC facilities | 33.51 | ref | ref | 61.19 | ref | ref |
| Sex | ||||||
| Male | 45.96 | ref | ref | 74.92 | ref | ref |
| Female | 48.28 | 1.05 (0.91 to 1.21) | 1.01 (0.89 to 1.15) | 75.80 | 1.01 (0.96 to 1.07) | 1.02 (0.97 to 1.06) |
| Age | ||||||
| 15–34 | 50.00 | ref | ref | 70.50 | ref | ref |
| 35–64 | 47.95 | 0.96 (0.77 to 1.19) | 0.97 (0.79 to 1.20) | 74.98 | 1.06 (0.97 to 1.17) | 1.08 (0.98 to 1.18) |
| 65 | 45.55 | 0.91 (0.72 to 1.15) | 0.88 (0.70 to 1.11) | 78.35 | 1.11 (1.01 to 1.23)* | 1.11 (1.00 to 1.23)* |
| Household income per capita | ||||||
| Poor | 58.47 | ref | ref | 76.52 | ref | ref |
| Middle | 58.53 | 1.00 (0.83 to 1.20) | 1.08 (0.91 to 1.29) | 74.31 | 0.97 (0.92 to 1.02) | 0.97 (0.92 to 1.02) |
| Rich | 40.86 | 0.70 (0.58 to 0.83)** | 0.83 (0.69 to 0.99)* | 74.94 | 0.98 (0.92 to 1.04) | 0.97 (0.91 to 1.03) |
| Educational achievement | ||||||
| Primary school or below | 57.99 | ref | ref | 76.51 | ref | ref |
| Junior high school | 51.37 | 0.89 (0.74 to 1.05) | 0.86 (0.73 to 1.02) | 74.61 | 0.98 (0.92 to 1.03) | 0.99 (0.94 to 1.05) |
| Senior high school | 44.18 | 0.76 (0.63 to 0.92)* | 0.75 (0.62 to 0.90)* | 74.15 | 0.97 (0.87 to 1.08) | 0.99 (0.90 to 1.09) |
| College and above | 36.41 | 0.63 (0.49 to 0.80)** | 0.69 (0.55 to 0.88)* | 59.52 | 0.78 (0.60 to 1.01) | 0.81 (0.65 to 1.02) |
| Social health insurance | ||||||
| No | 42.39 | ref | ref | 70.30 | ref | ref |
| Yes | 47.76 | 1.13 (0.88 to 1.44) | 1.25 (0.99 to 1.57) | 75.66 | 1.08 (0.95 to 1.22) | 1.07 (0.95 to 1.20) |
| Ethnicity | ||||||
| Han majority | 49.13 | ref | ref | 76.10 | ref | ref |
| Minorities | 37.42 | 0.76 (0.61 to 0.95)* | 0.81 (0.66 to 0.99)* | 64.39 | 0.85 (0.73 to 0.97)* | 0.89 (0.79 to 1.01) |
Data were weighted to yield provincially representative estimates.
Economic status was assessed by household income per capita and divided into three quantiles for each survey separately. The cut-off points were US$453.2 and US$906.3 for the 2008 survey, US$944.1 and US$1888.2 for the 2013 survey, and US$1007.1 and US$2323.8 for the 2018 survey respectively. 1$=6.62 RMB in 2018.
*p<0.05, **p<0.001.
†Adjusting for year, type of diseases, sex, age, household income per capita, educational achievement, social health insurance and ethnicity.
PHC, primary health care; ref, reference group; RR, relative rate.