The utilization of health care services by people with type 2 diabetes living in slums in Tabriz, Iran, and sociodemographic factors that influence it: a cross-sectional study

Abstract

Background As one of the disadvantaged groups, slum-dwellers face health disparities. These disparities can also be attributed to inequalities in health care utilization. Therefore, this study aimed to investigate health care utilization among patients with type 2 diabetes living in Tabriz's slums in 2022. Methods A cross-sectional study was conducted. Our study included participants who were over 18 years old, did not suffer from physical and psychological disabilities and had lived in slums for at least 5 years. 13155 patients with type 2 diabetes live in slums in Tabriz, according to the official statistics of the Vice Chancellor for Health at Tabriz University of Medical Sciences. Thus, we selected 400 patients using stratified systematic random sampling. A questionnaire was used to collect data, and SPSS version 22 was used to analyze the results. Results Of the 400 patients, 215 were female (53.8%), 323 were illiterate or could read and write (58%) and 303 had low income (75.2%). Only 15% had supplementary health insurance, while 82.3% had basic coverage. Although 49.8% of patients felt they needed outpatient services, only 38.3% were able to receive them. A blood sugar test is the most frequently received service (50%), while psychological counseling is the least frequently received consultation (3.30%). Outpatient services were used more frequently by patients with higher socioeconomic status and those with diabetes complications (P 0.05). The utilization of inpatient services was higher among older and less educated people (P 0.05). Conclusion Among slum-dwellers with type 2 diabetes, health care utilization is low. The government and health system should focus on providing adequate education about diabetes and its importance, empowering slum-dwellers to improve self-care and disease management, expanding public insurance coverage, and sufficient coverage of costs by insurance organizations.

Barriers and Facilitators to Health-seeking Behaviors and Self-care Practices of Older Adults in Rural India, A Mixed Method Study

“…The review revealed that individual, health system and contextual factors in uence type 2 diabetes management among slum dwellers. The review recommended that policymakers use the ndings to reduce barriers and augment facilitators of type 2 diabetes management among slum dwellers (34). A study conducted in 2023 explored barriers to health care utilization among patients with type 2 diabetes living in slums from the providers' perspective.…”

“…Self-e cacy was measured using the 10-item General Self-E cacy Scale (22), which assesses the perceived ability to cope with di cult demands in life on a 4-point Likert scale. The total score ranges from 10-40 points and is categorized as low (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), moderate (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), or high (31)(32)(33)(34)(35)(36)(37)(38)(39)(40).…”