Background:
Chronic diseases are considered one of the major causes of illness, disability and death worldwide. Chronic illness leads to a huge health and economic burden, especially in low- and middle-income countries. This study examined disease-stratified healthcare utilisation (HCU) in adult Bangladesh patients with chronic diseases from a gender perspective.
Methods:
Data from the nationally representative Household Income and Expenditure Survey 2016-2017 consisting of 12,005 patients with diagnosed chronic diseases was used. Gender differentiated chronic disease stratified-analytical exploration was performed using logistic regression to identify the potential factors for higher or lower utilisation of healthcare services after step-by-step adjusting for independent confounding factors.
Results:
The five most prevalent chronic diseases among patients were gastric/ulcer (Male/Female (M/F):16.77% / 16.40%), arthritis/rheumatism (M/F:13.70% / 13.86%), respiratory diseases/asthma/bronchitis (M/F: 12.09% / 12.55%), chronic heart disease (M/F: 8.30% / 7.41%), and blood pressure (M/F: 8.20% / 8.87%). Eighty-six percent of patients with chronic diseases utilised health care services during the previous 30 days. Although most patients received outpatient healthcare services, a substantial difference in HCU among employed male (53%) and female (8%) patients were observed. Chronic heart disease patients were more likely to utilise health care than other disease types for both genders while the magnitude of HCU was significantly higher in males (OR = 2.22; 95% CI:1.51-3.26) than their female counterparts (OR = 1.44; 1.02-2.04). A similar association was observed among patients with diabetes and respiratory diseases.
Conclusion:
Emerging burden of chronic diseases were observed in Bangladesh. Patients with chronic heart disease utilised more healthcare services than patients experiencing other chronic diseases. The distribution of HCU varied by patient’s gender for the empolyment status. Risk-pooling mechanisms and access to free or low-cost healthcare services among the most disadvantaged people might enhance their universal health coverage.