Types of community health services selected by urban and suburban residents in Nanjing and influencing factors

Objective: The purpose of the current study was to determine the types of community health services selected by urban and suburban residents in Nanjing and the influencing factors in an effort to improve the community health services to better meet the residents’ demands.

Methods: Between 15 May 2013 and 15 June 2013, eight community health service centers from four districts in Nanjing (Gulou District and Baixia District in urban areas and Jiangning District and Pukou District in suburban areas; two centers from each district) were selected using a stratified random sampling method of investigation sites. After an intercept interview with 487 community residents, univariate and multivariate analyses were performed by means of logistic regression.

Results: Among the 487 users of community health services, there were 241 residents from urban areas (49.5%) and 246 residents from suburban areas (50.5%). Among the respondents, there were 191 (39.2%) who usually received medical treatment from community health service institutions, including 74 (38.7%) from urban areas and 117 (61.3%) from suburban areas. The analysis showed that the factors which influenced urban residents in Nanjing to choose community health services for medical treatment included income, payment terms of medical fees, reasonable prices, medical fees, and expenses for medications, while factors influencing suburban residents to choose community health services for medical treatment included income, level of education, carrier, medical institutions selected when feeling severely ill, availability of preventive health services, availability of health counseling services, medical fees, and expenses for medications. Based on an analysis of the results by means of unconditioned binary logistic stepwise regression, the factors influencing whether or not the urban residents chose community health services for medical treatment included gender, age, level of education, payment terms of medical fees, treatment environment, and expenses for medications, while the factors influencing suburban residents included availability of preventive health services and expenses for medications.

Conclusion: There was a difference between the types of community health services selected by residents in urban and suburban areas of Nanjing and factors influencing the selection of services were different. Community health service institutions in different areas should strengthen their own service capability according to the local residents’ health demands.