Predicting Treatment-Seeking Behavior in Guatemala: A Comparison of the Health Services Research and Decision-Theoretic Approaches

This study attempts to identify and describe factors associated with the choice of a health care source in rural Guatemala. Because of limited choice options, rural Guatemala makes an excellent location for studying the factors that affect utilization patterns. Illness case histories were collected...

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Bibliographic Details
Published in:Medical anthropology quarterly 1997-06, Vol.11 (2), p.224-245
Main Authors: Weller, Susan C., Ruebush, Trenton R., Klein, Robert E.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Assets
Child
Decision Making
Decision making models
Discriminant Analysis
Diseases
Economic resources
Female
Guatemala
Healers
Health care
Health Care Utilization
Health services
Health Services Research
Households
Humans
Male
Medical anthropology
Medical Decision Making
Modeling
Models, Psychological
Patient Acceptance of Health Care
Pharmacies
Physicians
Predictive Value of Tests
Reproducibility of Results
Research Design - standards
Rural Health Services - utilization
Surveys and Questionnaires
Treatment Methods
Villages
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Summary:This study attempts to identify and describe factors associated with the choice of a health care source in rural Guatemala. Because of limited choice options, rural Guatemala makes an excellent location for studying the factors that affect utilization patterns. Illness case histories were collected from a random sample of 270 households in six villages. Then, two different methodological approaches were used to predict treatment actions. First, a sociobehavioral model, which encompasses enabling, predisposing, and need factors, was used to predict treatment choices. Using discriminant analysis we identified factors associated with the use of home remedies, a pharmacy, the health post, a physician, or folk healer. In a second, parallel study, descriptive interviews were used to identify important factors in choosing a treatment strategy. From these interviews, and from responses to hypothetical illness cases, we developed a decision model of treatment actions. Both models were tested against the set of illness cases. Results indicate that both approaches identify similar variables (especially, severity), although selection of variables through the multivariate analysis was much more successful in predicting treatment actions.
ISSN:0745-5194
1548-1387
DOI:10.1525/maq.1997.11.2.224