The Department of Endocrinology, 
Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia.
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
- George Institute for Global Health, University of New South Wales, Sydney, Australia.
- Department of Cardiology, Westmead Hospital, Sydney, Australia.
- Sydney Medical School, University of Sydney, Sydney, Australia.
- George Institute for Global Health, New Delhi, India.
- Public Health and Community Medicine, Central University of Kerala, Kasaragod, India.
- Non-Communicable Diseases and Implementation Science, Baker Heart and Diabetes Institute, Melbourne, Australia.
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
- Rishi Valley Rural Health Centre, Chittoor District, India.
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India.
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, India.
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Australia.
Chronic illness Vol. 19 · Issue 4 · pp. 873-888
PMID 36744377 DOI 10.1177/17423953231153550
Cite This Article
Sojib Bin Zaman, Roger G Evans, Clara K Chow, Rohina Joshi, Kavumpurathu R Thankappan, Brian Oldenburg, Ajay S Mahal, Kartik Kalyanram, Kamakshi Kartik, Michaela A Riddell, Oduru Suresh, Nihal Thomas, Gomathyamma K Mini, Pallab K Maulik, Velandai K Srikanth, Amanda G Thrift. Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India. Chronic illness. 2023;19(4):873-888. doi:10.1177/17423953231153550
Abstract
OBJECTIVES: To assess the prevalence and determinants of cardiometabolic disease (CMD), and the factors associated with healthcare utilisation, among people with CMD.
METHODS: Using a cross-sectional design, 11,657 participants were recruited from randomly selected villages in 3 regions located in Kerala and Andhra Pradesh from 2014 to 2016. Multivariable logistic regression was used to identify factors independently associated with CMD and healthcare utilisation (public or private).
RESULTS: Thirty-four per cent (n = 3629) of participants reported having ≥1 CMD, including hypertension (21.6%), diabetes (11.6%), heart disease (5.0%) or chronic kidney disease (CKD) (1.6%). The prevalence of CMD was progressively greater in regions of greater socio-economic position (SEP), ranging from 19.1% to 40.9%. Among those with CMD 41% had sought any medical advice in the last month, with only 19% utilising public health facilities. Among people with CMD, those with health insurance utilised more healthcare (age-gender adjusted odds ratio (AOR) (95% confidence interval (CI)): 1.31 (1.13, 1.51)) as did those who reported accessing private rather than public health services (1.43 (1.23, 1.66)).
DISCUSSION: The prevalence of CMD is high in these regions of rural India and is positively associated with indices of SEP. The utilisation of outpatient health services, particularly public services, among those with CMD is low.
Keywords
- Cardiometabolic diseases
- India
- health insurance
- healthcare disparities
- private facilities
