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Meta-Analysis
. 2025 Apr 28:13:1583075.
doi: 10.3389/fpubh.2025.1583075. eCollection 2025.

Influencing factors of patients' behavior of healthcare seeking: a meta-analysis in China

Yongtao Song  1 , Mingzhe Wu  1 , Hailong Feng  2
Affiliations
Meta-Analysis

Influencing factors of patients' behavior of healthcare seeking: a meta-analysis in China

Yongtao Song et al. Front Public Health. .

Abstract

Objectives: Understanding patient's healthcare seeking behavior (BHS) and identifying the determinants influencing BHS can optimize the allocation of medical resources and enhance the efficacy of healthcare systems. The purpose of this study is to identify the influencing factors of patients' BHS and to assess the extent and variation in their impact on BHS.

Methods: Drawing upon the Anderson Behavioral Model of Health Service Utilization, we summarized the factors influencing patients' BHS into three categories, and examined empirical journal articles published from 2010 to 2023 using meta-analysis. In addition, the Bayesian analysis of variance was introduced to explore the influence of moderators.

Results: A total of 39 empirical journal articles were finally identified for meta-analysis. Ten out of the thirteen factors have a significant and positive influence on BHS, with the exception of trust in medical institutions (z = 0.176, p = 0.077), health record (z = 1.942, p = 0.052), and medical expenses (z = 0.1846, p = 0.065). The results of moderating effect analysis indicate that there is a significant difference in the impact of age (p < 0.001), education level (p < 0.05), family income (p < 0.001), medical insurance (p < 0.001), illness severity (p < 0.01), and healthcare service reputation (p < 0.001) on BHS.

Conclusion: There is a positive and significant influence of the antecedent variables (self-rated health, distance to medical facilities, illness severity, age, family income, education level, marital status, medical insurance, awareness of hierarchical healthcare, health record, and healthcare service reputation) on BHS. Furthermore, the influences of family income, medical insurance, and illness severity on BHS in developed areas are stronger than that in underdeveloped areas, while the influences of age, education level, and healthcare service reputation on BHS in underdeveloped areas are stronger than that in developed areas.

Keywords: behavior of healthcare seeking; hierarchical medical system; influencing factors; meta-analysis; moderating effect analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Research model.
Figure 2
Figure 2
Flow chart of the study selection process.
Figure 3
Figure 3
Funnel plot of publication deviation test.
Figure 4
Figure 4
P-curve distribution. The observed p-curve includes 134 statistically significant (p < 0.05) results of which 130 are p < 0.025. There were 9 additional results entered but excluded from p-curve because they were p > 0.05.
See this image and copyright information in PMC

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References

    1. Godager G, Iversen T, Ma CA. Competition, gatekeeping, and health care access. J Health Econ. (2015) 39:159–70. doi: 10.1016/j.jhealeco.2014.11.005, PMID: - DOI - PubMed
    1. Mwabu GM. Referral systems and health care seeking behavior of patients: an economic analysis. World Dev. (1989) 17:85–91. doi: 10.1016/0305-750X(89)90224-6 - DOI
    1. Freeman M, Savva N, Scholtes S. Gatekeepers at work: an empirical analysis of a maternity unit. Manag Sci. (2016) 63:3147–67. doi: 10.1287/mnsc.2016.2512, PMID: - DOI - PubMed
    1. Zhou Z, Zhao Y, Shen C, Lai S, Nawaz R, Gao J. Evaluating the effect of hierarchical medical system on health-seeking behavior: a difference-in-differences analysis in China. Soc Sci Med. (2021) 268:113372. doi: 10.1016/j.socscimed.2020.113372, PMID: - DOI - PubMed
    1. Li X, Krumholz HM, Yip W, Cheng K, DeMaeseneer J, Meng Q. Quality of primary health care in China: challenges and recommendations. Lancet. (2020) 395:1802–12. doi: 10.1016/S0140-6736(20)30122-7, PMID: - DOI - PMC - PubMed

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