Factors Associated with Health Services Access among Chronic Disease Patients During an Outbreak of Coronavirus Disease in 2019

Abstract

     This cross-sectional study aimed to investigate factors associated with health service access among chronic disease patients during an outbreak of coronavirus disease in 2019 in Praprom district, Nakhon Si Thammarat province. The participants were 8,197 chronic disease patients living in Phra Phrom District. Determine the sample size by using the proportional estimation formula if the population is known, yielding a sample size of 441. Data was collected from June 1 to June 30, 2022, by using a questionnaire. Data analysis was performed using descriptive analysis, consisting of percentage, mean, standard deviation, maximum and minimum values, and inferential statistics, including odds ratio, 95% CI, and binary logistic regression.

     The results showed that overall social support was at a high level and access to health services was at a good level. When considering each aspect, all aspects were average at a good level, except for the ability to pay for services, which was not at a good level. Factors associated with access to health services included: 1) distance from home to chronic disease service units, which distances between 6.01 and 9.00 kilometers were 3.26 times more likely to be able to access health services compared to distances between 0.00 and 3.00 kilometers; 2) patients with diabetes, high blood pressure, or cardiovascular disease had a 3.55 times higher chance of accessing health services compared to patients with stroke, chronic obstructive pulmonary disease, emphysema, or cancer; 3) a high level of emotional support had a 9.56 times better chance of accessing health services compared to low-moderate levels; 4) a high level of help support had a 11.34 times more likely  to access health services compared to low-moderate levels; 5) a high level of information support had a 23.26 times better chance of accessing health services compared to a low-moderate level; and 6) a high level of reflection support or self-evaluation support had 9.86 times more likely to access health services compared to low-moderate levels.

     Therefore, health service teams should develop and support factors that facilitate access to health services, especially for patients with cerebrovascular disease, obstructive pulmonary disease, emphysema, and cancer. In addition, communities and localities should develop factors that promote journeys, emotional management, assistance, and support in order to create opportunities for more effective access to health services for patients with chronic diseases during the outbreak of coronavirus disease 2019 or emerging infectious diseases.