Factors associated with the utilisation of primary care services: a cross-sectional study in public and private facilities in Albania

• Published in: BMJ open 2020-12, Vol.10 (12), p.e040398
• Main Authors: Gabrani, Jonila, Schindler, Christian, Wyss, Kaspar
• Format: Article
• Language: English
• Subjects: Albania; Complementary Medicine; Cross-Sectional Studies; Female; Health care policy; Health insurance; health policy; Health services; Hospitals; Humans; international health services; Male; Middle Aged; Population; Primary care; Primary Health Care; Private Facilities; Public sector; Public services; quality in health care; Quality of Health Care; Sociodemographics; State budgets; Trends
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-040398

ObjectivesTo identify key factors influencing the utilisation of governmental and private primary healthcare services in Albania.DesignA cross-sectional health facility survey using a 4-point Likert scale questionnaire to rank the importance of factors driving services utilisation.SettingExit interviews with patients who consulted one of 23 primary care providers (18 public and 5 private) in Fier district of Albania from the period of July–August 2018.ParticipantsRepresentative sample of 629 adults ≥18 years of age.Main outcomes measures(1) Factors influencing the decision to visit a governmental or private primary care provider and (2) the association of sociodemographic characteristics and patients’ decision to attend a given provider. Data were analysed using mixed logistic regression models.ResultsNearly half of the participants in this study were older than 60 years (45%). The majority (63%) reported to suffer from a chronic condition. Prevailing determinants for choosing a provider were ‘quality of care’ and ‘healthcare professionals’ attitudes. Solely looking at patients using a public provider, ‘geographical proximity’ was the most important factor guiding the decision (85% vs 11%, p