The impact of medical and socioeconomic factors on refusal to seek medical care

Current research lacks a comprehensive analysis of the complex relationship between various factors, particularly socioeconomic and medical, and the decision-making process to seek immediate admission to healthcare facilities.

Aim. To identify behavioral patterns among citizens of the Russian Federation when facing medical issues and the factors influencing them.

Materials and methods. A specially designed questionnaire was used to assess citizens’ behavior in response to medical problems, including sections on respondents’ general characteristics (12 questions) and aspects of healthcare provision (17 questions). Statistical analysis was performed using Statistica for Windows 10.0, Stata, and R-Studio.

Results. The study involved a sample of 2,717 respondents aged 18 and over from 85 regions of the Russian Federation. The median age of the participants was 42.4 years. The majority of respondents (64.8 %) reported seeking professional medical help when health issues arose, which was characterized as rational health behavior. Approximately one-third (29.4 %) preferred self-treatment using pharmaceuticals and “folk remedies”, while 4.5 % took no action, believing the illness would “resolve on its own”. A small proportion (0.6 %) sought assistance from individuals practicing non-traditional methods. These latter three patterns were classifi ed as irrational health behavior. The highest proportion of respondents demonstrating irrational healthcare-seeking behavior was observed among individuals aged 35–44, those with low fi nancial status, never-married individuals, the unemployed, and those unwilling to have children. Medical factors contributing to irrational behavior included distrust in the healthcare system and low adherence to treatment and disease prevention. A high level of satisfaction with the most recent visit to a healthcare facility was identified as a factor promoting rational healthcare-seeking behavior.

Conclusion. The medical and socio-economic factors associated with rational healthcare-seeking behavior identified in this study are modifiable by the healthcare system and hold value for developing interventions aimed at promoting appropriate medical care utilization.

1. Karimova L.K., Gimaeva Z.F., Bakirov A.B., et al. Sudden Death in the Workplace from Common Diseases and Preventive Measures (Based on the Republic of Bashkortostan). Perm Medical Journal. 2021; 38(1): 123–134 (In Russian). https://doi.org/10.17816/pmj381123-134. EDN: XDCNHM

2. Conboy N.E., Nickow A., Awoonor-Williams J.K., et al. Self-reported delays in care-seeking in West Africa during the first wave of the COVID-19 pandemic. BMC Health Serv Res. 2023; 23: 785. https://doi.org/10.1186/s12913-023-09812-x. PMID: 37481561; PMCID: PMC10363320

3. Tiruneh G.A., Arega D.T., Kassa B.G. Delay in making decision to seek care on institutional delivery and associated factors among postpartum mothers in South Gondar zone hospi-tals, 2020: A cross-sectional study. Heliyon. 2022; 8(3): e09056. https://doi.org/10.1016/j.heliyon.2022.e09056. PMID: 35284676; PMCID: PMC8908018

4. Plutov L.E. Gender specificity of psychological help-seeking among russian adolescents. SocioDynamics. 2023; 10: 44–57 (In Russian). https://doi.org/10.25136/2409-7144.2023.10.68771. EDN: LHRWYK

5. Kislitsyna O.A., Chubarova T.V. Factors influencing Russians’ applications for medical assistance: gender aspect. Woman in Russian society. 2023; 2: 94–108 (In Russian). https://doi.org/10.21064/WinRS.2023.2.7. EDN: JHXBVJ

6. Cherkasov S. N., Polozkov O. I., Fedyaeva A.V., Kamaev Yu. O. The influence of the level of education on the behavioral patterns associated with the access to medical care of the population of older age groups. Medical & pharmaceutical journal «PULSE». 2021; 23(7): 31–37 (In Russian). https://doi.org/10.26787/nydha-2686-6838-2021-23-7-31-37. EDN: XXMMEI

7. Khanam F., Shariful Islam M., Akter J. Factors related to delay in seeking medical care among patients with acute myocardial infarction in Dhaka. J Cell Mol Biol. 2019; 10(1): e92475. https://doi.org/10.5812/jjhr.92475

8. Yousaf O., Grunfeld E.A., Hunter M.S. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol. Rev. 2015; 9(2): 264–276. https://doi.org/10.1080/17437199.2013.840954. PMID: 26209212

9. Scott S., Walter F. Studying Help-Seeking for Symptoms: The Challenges of Methods and Models: Studying Help-Seeking for Symptoms. Soc. Personal. Psychol. Compass. 2010; 4(8): 531–547. https://doi.org/10.1111/j.1751-9004.2010.00287.x

10. Suvorova E.I., Shalnova S.A., Kontsevaya A.V., et al. Association of risk factors for non-communicable diseases with health care resources utilization and temporary disability according to data of population study in Russian Federation. Rational Pharmacotherapy in Cardiology. 2018; 14(1): 70–76 (In Russian). https://doi.org/10.20996/1819-6446-2018-14-1-70-76. EDN: YTITEY

11. Petersen J., Kontsevaya A., McKee M., et al. Primary care use and cardiovascular disease risk in Russian 40-69-year olds: a cross-sectional study. J. Epidemiol Community Health. 2020; 74(9): 692–967. https://doi.org/10.1136/jech-2019-213549. PMID: 3236658

12. Viera A.J., Thorpe J.M., Garrett J.M. Effects of sex, age, and visits on receipt of preventive healthcare services: a secondary analysis of national data. BMC Health Serv Res. 2006; 6: 15. https://doi.org/10.1186/1472-6963-6-15. PMID: 16504097; PMCID: PMC1402283

13. Bista S., Yu R., Shete S. Factors associated with healthcare avoidance among US adults: analyses of the 2019 healthy information national trends survey. J Fam Med. 2021; 8(9): 1280. https://doi.org/10.26420/jfammed.2021.1280