Table 5.
Associations of service density and proximity with outpatient care utilisation, by type of district
| Regency of low population density |
Regency of high population density |
Cities |
||||
|---|---|---|---|---|---|---|
|
SPR (95% CI)* |
OR (95% CI) † |
SPR (95% CI)* |
OR (95% CI) † |
SPR (95% CI)* |
OR (95% CI) † |
|
|
Service density | ||||||
|
GP ratio: | ||||||
| Low |
5.53 (5.33-5.71) |
1.00 |
7.56 (7.44-7.68) |
1.00 |
12.58 (11.58-13-57) |
1.00 |
| Medium |
6.03 (5.88-6.18) |
0.94 (0.73-1.21) |
7.93 (7.75-8.12) |
0.95 (0.80-1.13) |
8.89 (8.47-9.07) |
0.63 (0.38-1.06) |
| High |
7.86 (7.65-8.07) |
1.07 (0.79-1.46) |
9.62 (9.32-9.91) |
1.17 (0.89-1.53) |
9.21 (9.11-9.49) |
0.79 (0.46-1.37) |
|
PHC ratio: | ||||||
| Low |
3.21 (2.93-3.50) |
1.00 |
7.78 (7.66-7.90) |
1.00 |
9.57 (9.36-9.78) |
1.00 |
| Medium |
5.51 (5.35-5.66) |
1.17 (0.71-1.92) |
7.97 (7.79-8.16) |
1.17 (0.93-1.48) |
8.75 (8.48-9.01) |
0.98 (0.81-1.20) |
| High |
7.57 (7.42-7.73) |
1.14 (0.67-1.95) |
8.35 (8.08-8.62) |
1.24 (0.95-1.63) |
9.46 (8.81-10.10) |
1.01 (0.72-1.43) |
|
Nurse ratio: | ||||||
| Low |
5.02 (4.83-5.22) |
1.00 |
7.44 (7.33-7.55) |
1.00 |
10.38 (9.87-10.89) |
1.00 |
| Medium |
6.73 (6.56-6.89) |
1.23 (0.92-1.61) |
8.76 (8.57-8.95) |
1.22 (1.01-1.47) |
9.31 (9.03-9.59) |
1.05 (0.72-1.53) |
| High |
6.99 (6.68-7.17) |
1.14 (0.82-1.58) |
8.62 (8.32-8.92) |
1.23 (0.93-1.62) |
9.04 (8.83-9.25) |
1.08 (0.72-1.63) |
|
Service proximity | ||||||
|
Travel time: | ||||||
| Short |
6.47 (6.24-6.69) |
1.00 |
9.06 (8.87-9.25) |
1.00 |
9.82 (9.63-10.02) |
1.00 |
| Medium |
5.86 (5.69-6.04) |
0.94 (0.72-1.21) |
7.52 (7.38-7.65) |
0.97 (0.82-1.17) |
8.90 (8.56-9.24) |
1.08 (0.84-1.38) |
| Long |
6.85 (6.69-7.01) |
0.86 (0.67-1.11) |
7.41 (7.24-7.58) |
0.98 (0.79-1.22) |
6.27 (5.85-6.70) |
0.71 (0.51-1.01) |
|
Travel costs: | ||||||
| Low |
7.01 (6.72-7.31) |
1.00 |
9.20 (9.05-9.35) |
1.00 |
10.75 (10.52-10.97) |
1.00 |
| Medium |
5.57 (5.39-5.74) |
0.74 (0.54-1 · 01) |
6.78 (6.63-6.91) |
0.78 (0.66.0.93) |
7.65 (7.38-7.92) |
0.89 (0.72-1.11) |
| High |
6.81 (6.66-6.96) |
0.81 (0.60-1 · 10) |
7.28 (7.06-7.50) |
0.88 (0.70-1.11) |
6.86 (6.50-7.23) |
0.85 (0.59-1.22) |
|
ICC (95% CI)‡: | ||||||
| Province-level |
- |
0.010 (0.002-0.040) |
- |
0.002 (0.000-0.164) |
- |
0.000 (0.000-1.000) |
| District-level |
- |
0.110 (0.091-0.134) |
- |
0.058 (0.047-0.071) |
- |
0.041 (0.030-0.057) |
|
MOR (95% CrI):§ | ||||||
| Province-level |
- |
1.20 (1.00-1.33) |
- |
1.08 (1.00-1.20) |
- |
1.00 |
| District-level | - | 1.78 (1.66-1.90) | - | 1.52 (1.44-1.59) | - | 1.41 (1.34-1.50) |
SPR – standardised prevalence rate, CI – confidence interval, OR – odds ratio, CI – confidence interval, GP – general practitioner, PHC – public primary health centre, ICC – intra-class correlation, MOR – median odds ratio, CrI – credible interval
*Age and sex-standardised prevalence rate, per 100 persons.
†Odds ratio adjusted to age, sex, and self-assessed health status, population density, wealth, education level, and health insurance (with 95% confidence interval).
‡Intraclass correlation (with 95% confidence interval).
§Median odds ratio (with 95% credible interval).