Factors Affecting Utilization of an Urban Community Health Center in the Philippines: A Cross-Sectional Study

Lissa Luz Calimag, Marifel Raymundo

Keywords: Community Health Center, Utilization, Urban

Background:
The local health center, or the LHC, is the locus of public health service delivery in the urban communities of Makati, Philippines. It should be the first-line for consultation and should be able to address most health concerns of the community. Despite the many services offered in the LHC, residents still opt to consult in the city hospital or in private institutions and this study sought to understand why.

Research questions:
This study aimed to determine the correlation between demographic variables of residents and the utilization of the LHC and between community perception of the LHC and utilization of the LHC in two urban communities.

Method:
Utilization of the LHC was operationally defined as any consultation in the LHC in the past year, regardless of occurrence of illness. The survey questionnaire utilized the Patient Satisfaction Questionnaire-18 or PSQ-18 which has a 5-point Likert Scale. Other possible factors affecting utilization based on related literature were added to the survey questionnaire.

Results:
Results showed that utilization of the LHC had a weak positive correlation with older age and having more co-morbid illnesses. Other factors which showed a positive though weak correlation with consulting in the LHC were community perception regarding General Satisfaction, Availability of doctors, and Availability of free medications, however these aspects were rated highly by residents overall. Community perception on Patient-Doctor Relationship also showed a weak positive correlation with consulting in the LHC and had a low community perception rating, suggesting this is the key issue in the utilization of the LHC.

Conclusions:
Utilization of the LHC were correlated with older age, having more co-morbid illnesses, and community perception of General Satisfaction, Availability of doctors, Availability of free medications, and Patient-Doctor Relationship.

Points for discussion:
These results coincide with a similar study in Baguio, Philippines by Sy et al. (2019) that showed the top 3 important factors for choosing a health care facility among bypassers of their nearby health facilities were Availability of doctors, Sufficient supply of medicines, and Satisfactory health service.

The results of this study contrast with a few studies in other countries such as South Korea, Albania, and rural Southern Nigeria where distance and transportation difficulties were associated with lower utilization of public primary health care facilities (Han et al., 2016, Gabrani et al., 2018, Adam et al., 2014).

Additionally, long waiting time was a barrier to utilization of a community health center according to Adam et al. (2014) but our results showed that long waiting time for consultation was not correlated with utilization of the LHC.