The burden of chronic diseases and patients' preference for healthcare services among adult patients suffering from chronic diseases in Bangladesh

Rashidul A Mahumud; Marufa Sultana; Satyajit Kundu; Md A Rahman; Sabuj K Mistry; Joseph K Kamara; Mostafa Kamal; Mohammad A Ali; Md G Hossain; Cristy Brooks; Asaduzzaman Khan; Khorshed Alam; Andre M N Renzaho

doi:10.1111/hex.13634

The burden of chronic diseases and patients' preference for healthcare services among adult patients suffering from chronic diseases in Bangladesh

Health Expect. 2022 Dec;25(6):3259-3273. doi: 10.1111/hex.13634. Epub 2022 Oct 20.

Authors

Rashidul A Mahumud^{1

2

3}, Marufa Sultana⁴, Satyajit Kundu⁵, Md A Rahman⁶, Sabuj K Mistry^{7

8

9}, Joseph K Kamara¹⁰, Mostafa Kamal¹¹, Mohammad A Ali^{3

12}, Md G Hossain¹, Cristy Brooks^{13

14}, Asaduzzaman Khan¹⁵, Khorshed Alam³, Andre M N Renzaho^{13

14

16}

Affiliations

¹ Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh.
² NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
³ School of Business, Faculty of Business, Education, Law and Arts, and Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia.
⁴ Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
⁵ Department of Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh.
⁶ Development Studies Discipline, Khulna University, Khulna, Bangladesh.
⁷ Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
⁸ ARCED Foundation, Mirpur, Dhaka, Bangladesh.
⁹ Department of Public Health, Daffodil International University, Dhaka, Bangladesh.
¹⁰ Regional Director, Humanitarian & Emergency Affairs, World Vision International, East Africa Regional Office, Karen, Nairobi, Kenya.
¹¹ BL Deakin Business School, Faculty of Business and Law, Deakin University, Geelong, Victoria, Australia.
¹² Quality Use of Medicines and Pharmacy Research Centre (QUMPRC), Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
¹³ Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.
¹⁴ School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
¹⁵ School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland, Australia.
¹⁶ Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia.

Abstract

Background: Low- and middle-income countries (LMICs) have a disproportionately high burden of chronic diseases, with inequalities in health care access and quality services. This study aimed to assess patients' preferences for healthcare services for chronic disease management among adult patients in Bangladesh.

Methods: The present analysis was conducted among 10,385 patients suffering from chronic diseases, drawn from the latest Household Income and Expenditure Survey 2016-2017. We used the multinomial logistic regression to investigate the association of chronic comorbid conditions and healthcare service-related factors with patients' preferences for healthcare services.

Results: The top four dimensions of patient preference for healthcare services in order of magnitude were quality of treatment (30.3%), short distance to health facility (27.6%), affordability of health care (21.7%) and availability of doctors (11.0%). Patients with heart disease had a 29% significantly lower preference for healthcare affordability than the quality of healthcare services (relative risk ratio [RRR] = 0.71; 0.56-0.90). Patients who received healthcare services from pharmacies or dispensaries were more likely to prefer a short distance to a health facility (RRR = 6.99; 4.80-9.86) or affordability of healthcare services (RRR = 3.13; 2.25-4.36). Patients with comorbid conditions were more likely to prefer healthcare affordability (RRR = 1.39; 1.15-1.68). In addition, patients who received health care from a public facility had 2.93 times higher preference for the availability of medical doctors (RRR = 2.93; 1.70-5.04) than the quality of treatment in the health facility, when compared with private service providers.

Conclusions: Patient preferences for healthcare services in chronic disease management were significantly associated with the type of disease and its magnitude and characteristics of healthcare providers. Therefore, to enhance service provision and equitable distribution and uptake of health services, policymakers and public health practitioners should consider patient preferences in designing national strategic frameworks for chronic disease management.

Patient or public contribution: Our research team includes four researchers (co-authors) with chronic diseases who have experience of living or working with people suffering from chronic conditions or diseases.

Keywords: Bangladesh; chronic diseases; healthcare services; patient preferences.

MeSH terms

Adult
Bangladesh
Chronic Disease
Health Services Accessibility
Health Services*
Humans
Logistic Models
Patient Preference*