Association Between Health-Seeking Behavior and Health Service Utilization Among Slum Residents: A cross-sectional study from a developing country

Abstract

Background: Health-seeking behavior (HSB) refers to how individuals respond to health issues and significantly influences health service utilization (HSU). This study examines the association between HSB and HSU among marginalized populations in Iran. 

Methods: This cross-sectional study was conducted in 2020 and targeted adults (aged ≥18 years) residing in the slum areas of Kerman city, southeastern Iran. A cluster sampling method was employed based on population census data provided by the district health center, identifying 233 clusters. The final sample included 840 households. Data were collected through face-to-face interviews using two standardized and validated questionnaires assessing HSB and HSU. Three trained research teams conducted the interviews. Descriptive statistics and logistic regression analyses were performed using STATA 14 software.

Results: Multivariate analysis revealed that marital status, household size, treatment duration, current illness experience, disease acceptance, and stress were positively associated with inpatient service utilization (p<0.01). In contrast, higher education levels and greater disease-related knowledge were inversely associated with inpatient service use (p<0.01).
Regarding outpatient services, factors such as insurance status, initial consultation for illness, perception of received healthcare quality, illness concealment, and situational factors were linked to lower outpatient service utilization (p<0.01). Conversely, timely healthcare access and the influence of advertising and health information accessibility were associated with increased outpatient service use (p<0.01).

Conclusion: This study highlights the significant role of demographic factors and HSB in shaping inpatient and outpatient service utilization. Given the adverse effects of marginalization on healthcare access, policymakers should prioritize improving economic and cultural conditions and implementing targeted educational initiatives, including media campaigns. Addressing financial barriers and introducing tailored interventions can reduce disparities and empower marginalized communities to access timely and appropriate healthcare services.