Factors Associated with the Delay in Seeing a Doctor: Evidence of Chinese Middle-Aged and Older Adults

Abstract

Background: There have been few studies concerning delayed medical attention among middle-aged and older adults, and in-depth analyses of delay duration and symptoms have been lacking.

Methods: In this cross-sectional study exploiting a face-to-face questionnaire survey, we investigated delays in seeing a doctor among ≥ 45-year-old people in Zhejiang, China over the past year, and analyzed relevant influencing factors through logistics regression.

Results: A total of 1034 people aged ≥45 years were enrolled, whose overall occurrence of delay in seeing a doctor was 28.24% (23.00% for older adults aged ≥60 years). Factors like the presence of 2 chronic diseases, intense social loneliness, and more health care needs contributed to the occurrence of delay in seeing a doctor (OR (95% CI) = 2.102 (1.252-3.529); OR (95% CI) = 1.030 (1.002-1.059); OR (95% CI) = 1.049 (1.002-1.099). Contrastively, factors like convenient access to medical care and good self-reported health status inhibited such occurrence OR (95% CI) = 0.321 (0.199-0.519); OR (95% CI) = 0.369 (0.183-0.745). The foremost reason was wanting to wait and see if the problem would get better on its own (117, 40.07%). Respiratory system disease (14.90%), dental problems (13.82%), and cardiac disease (13.61%) constituted the top 3 types of diseases whose treatments were delayed. Additionally, for the majority of older adults, the delay duration was 1-2 weeks (99, 33.90%), and the economic burden was the cause of the longest delay in seeing a doctor among middle-aged and older adults.

Conclusion: To alleviate the problem of delay in seeing a doctor among middle-aged and older adults, their families and society should enhance care for them and reduce their sense of social loneliness. Emphasis should be placed by the government on helping middle-aged and older adults with financial difficulties so that their medical convenience can be improved.

Keywords: China; cross-sectional study; delaying doctor visits; middle-aged; older adults.

Figure 1

Descriptive results of the reasons for delay in seeing a doctor. (A) The distribution of reasons for delay among different factors. The brackets mean P-values for group comparison (univariate analysis). For unordered variables (eg sex, hukou), the P-value is the result of Chi-square test. For rank ordered variables (eg age, education level), the P-value is result of Kruskal–Wallis test. *P<0.05, **P<0.01, ***P<0.001. (B) Social support scale scores (class by reasons) (C) Loneliness scale scores (class by reasons) (D) Need scale scores (class by reasons). The arrow means the need scores of Reason 4 are lower than other reasons.

Figure 2

Descriptive results of delay time for delay in seeing a doctor. (A) The distribution of delay time among different factors. No statistically significant differences were found between the groups. (B). Social support scale scores (class by delay time) (C). Loneliness scale scores (class by delay time) (D). Need scale scores (class by delay time). The arrow means the need scores of > 4 weeks are a little higher than other delay time.

Figure 3

The major disease symptoms for delay in seeing a doctor.

Figure 4

Interrelations among reasons for the delay, delay time, and disease symptoms. (A) The frequency heat map for the interrelation between the reasons for delay and disease symptoms (B). The frequency heat map for the interrelation between delay time and disease symptoms (C). The frequency heat map for the interrelation between delay time and the reasons for delay.