ميزان و عوامل موثر بر بهره مندي از خدمات خانه هاي بهداشت در شهرستان دماوند

Utilization of "Health Houses" in Damavand city

Objective(s): This survey investigates factors affecting Health House services utilization in Damavand, a small city in Tehran Province. Methods: This cross-sectional study was carried out on 400 people aged above 30 years who lived in the catchment area of different Health Houses (primary health care or PHC clinics) in Damavand in 2003-4. Fourteen out of the 27 existing Health Houses were selected at random. Systematic samples proportional to size of the target population were drawn in every village. Subjects completed questionnaires at their homes. Data analysis included chi-square and logistic regression and was performed using the SPSS package. Results: 49.5% of men and 77.1 % of women have reported that they were using Health House facilities from September 2002 to March 2004, while 24.5% of men and 20.3% of women did not. 26% of men and 2.6% of women have never used these services. The factors for non-utilization were: male sex, type of occupation, higher education, time spent getting to the Health House more than 20 minutes, waiting times above 20 minutes inside the Health House, providersʹ unfriendly behavior, lack of consultation regarding different services, physical environment of Health Houses, inappropriate service timing (P<0.001 for all), poor communication (P<0.04), long latent periods for hypertension-related disability, (P<0.02) and a refusal to admit the detrimental effects of HTN on life expectancy (P<0.01). Conclusion: Appropriate interventions addressing the above factors could improve service utilization.