title: Seeking, delaying, and avoiding routine health care services: patient perspectives.
abstract: OBJECTIVE
  To explore/identify patient perspectives regarding seeking, delaying, and avoiding health care services, particularly barriers and facilitators.
  
  
  METHODS
  Face-to-face interviews with health plan survey respondents.
  
  
  METHODS
  An integrated health plan providing comprehensive care to 480,000 people in Oregon and Washington.
  
  
  METHODS
  Willing respondents randomly selected to maximize heterogeneity within the following strata: gender, health care utilization, and self-reported alcohol consumption (indicator of health practices). Participants were 75 men and 75 women (150 total), 21 to 64 years old, with ≥12 months of health plan membership.
  
  
  METHODS
  Participants were recruited by letter (52.5% agreed). Data collection stopped when planned interviews were completed; saturation (the point at which additional interviews were not producing novel information) was achieved for key study questions. Semi-structured interviews were recorded, transcribed, and coded. Reviews of codes related to care seeking and feelings/attitudes about providers produced common themes.
  
  
  RESULTS
  Facilitators of care seeking included welcoming staff, collaborative relationships with providers, and education about the value of preventive care. Barriers included costs, time needed for appointments, and cumbersome processes. Some participants delayed procedures, some avoided care until absolutely necessary, others framed care as routinely necessary.
  
  
  CONCLUSIONS
  Increasing comfort, improving appointment and visit-related processes, having positive patient-physician relationships, and enhancing communication and clinician-provided education may facilitate appropriate use of preventive services. Further research is needed with larger, representative samples to evaluate findings.
authors: Carla A
authors: CA
authors: Green
authors: Kim M
authors: KM
authors: Johnson
authors: Bobbi Jo H
authors: BJ
authors: Yarborough
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D014861:Washington / Q000453:epidemiology; D055815:Young Adult
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