Determinants of healthcare utilization among sickle cell disease patients in the upper west region of ghana

Abstract

Sickle Cell Disease is a chronic disease of public health concern that accounts for significant mortalities and hospitalisation worldwide. Sickle cell disease (SCD) is marked by both immediate and long-term complications, frequently necessitating the utilization of healthcare services.There is a paucity of research on the determinants of care utilization. Therefore, the determinants of healthcare service use among people living with SCD should be identified and addressed. This study aimed to assess the utilization of healthcare services and its determinants among SCD patients in the Upper West Region. The study adopted the quantitative approach using a cross-sectional survey design involving a sample size of 248. SPSS version 22.0 software was used to analyse the data. Both descriptive and inferential statistics were used. The findings showed that 92% of the respondents had used healthcare services within the last 12 months. Specifically, SCD patients had utilised OPD services 62%, Emergency services 57.7% and Inpatient services 39.5% three or more times within the last 12months. It was also observed that 58% of the 248 respondents had poor accessibility to healthcare facilities providing SCD-specific care, with an overall mean of accessibility of 13.5. The major factors that were found to have influenced healthcare utilisation were age (p<0.001) and closeness to the healthcare facility (p <0.005). Healthcare service utilization was predicted by being aged 40+ years (AOR=12.6, 95%CI=1.40-113.81, p=0.024), and nearness to health facility (AOR=0.03, 95%CI=0.00-0.98, p=0.026). Efforts such as investment into healthcare infrastructure, incorporating SCD-specific care in all health facilities, and training specialists should be increased to improve accessibility, service availability, utilization, and quality of service.