Barriers to health care utilization among patients with type 2 diabetes living in slums:a qualitative study from providers’perspective  

作　　者：Fawzieh Ghammari Rahim Khodayari-zarnaq Habib Jalilian Masumeh Gholizadeh 

机构地区：[1]Department of Health Policy and Management,School of Management and Medical Informatics,Tabriz University of Medical Sciences,Tabriz,Iran [2]Department of Health Services Management,School of Health,Ahvaz Jundishapur University of Medical Sciences,Ahvaz,Iran

出　　处：《Global Health Research and Policy》2023年第1期414-422,共9页全球健康研究与政策（英文）

基　　金：supported by the Tabriz University of Medical Sciences under grant 68557.

摘　　要：Background Due to slum dwellers’deprivation,they are more likely to develop Type 2 Diabetes(T2D)and its complications.Type 2 Diabetes is a long-life disease that requires continuous health care utilization.One of the negative outcomes of slum-dwelling is health care underutilization.Therefore,this study aimed to understand barriers to health care utilization among those with T2D living in Tabriz slums,Iran,from the perspective of healthcare providers,in 2022.Methods A phenomenological approach was used in this study.Purposive sampling for conducting in-depth interviews was used to select 23 providers consisting of general practitioners,midwives,nutritionists,and public health experts.We conducted a content analysis using the 7 stages recommended by Colaizzi.We used four criteria recommended by Lincoln and Guba for ensuring the research’s trustworthiness.Results Three main themes and 8 categories were developed.Three main themes are 1)health care provision system barriers,including four categories:lack of motivation,non-availability of facilities and doctors,poor relationship between patients and providers,and disruption in the process 2)coverage problems,including two categories:insurance inefficiency,and limited access,and 3)contextual barriers,including two categories:environmental problems,and socioeconomic barriers.Conclusions Recommendations are presented in three levels to improve implementation.The health care system needs to modify the payment methods,Patients-providers relationship improvement,and increase the number of providers.Insurance organizations should consider sufficient coverage of costs for slum-dwellers with T2D and expand the benefits package for them.Government should consider infrastructure upgrading in slums to eliminate barriers related to slum-dwelling.Overall,health care utilization promotion needs intersection cooperation.

关 键 词：Health care utilization SLUMS Type 2 diabetes Qualitative study 

分 类 号：R58[医药卫生—内分泌]