Assessing Healthcare Access in Rural Algeria: A Survey-Based Cross-Sectional Analysis of Healthcare Utilization Based on Socioeconomic and Health Factors, Experiences, and Spatial Disparities

评估阿尔及利亚农村地区的医疗保健服务可及性:基于社会经济和健康因素、经验和空间差异的医疗保健利用情况调查横断面分析

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Abstract

BACKGROUND AND AIMS: Equitable access to healthcare constitutes a fundamental aspect of the Algerian health policy. Yet, no studies addressed determinants of healthcare access in rural areas. This study quantified healthcare utilization (HCU) in a remote Algerian village, and analyzed the associated socioeconomic and health-related factors, spatial disparities, and experiences with local healthcare services. METHODS: A survey-based, cross-sectional study was conducted among 400 adult residents of Boussemghoun village, located in the Saharan Atlas Mountains. A structured questionnaire quantified the utilization of 10 basic healthcare services over the past 12-months. Socioeconomic and health-related factors, spatial disparities, and experiences with local healthcare services were analyzed as the independent factors of high HCU using multivariate logistic regression. RESULTS: Among the participants, 39.7% had at least one chronic disease and 36.5% declared having traveled for healthcare during the past year. Levels of HCU were low across all care services, with the median (P75) HCU score was 4 (9) out of 33. Independent factors of high HCU included female (OR = 2.62, p = 0.003), widowed status (OR = 4.65, p = 0.026), high income (OR = 3.64, p = 0.048), taking 2+ chronic medications (OR = 3.61, p = 0.001), acute health issue in the past year (OR = 3.19, p = 0.013), interregional healthcare mobility (OR = 1.87, p = 0.041), longer travel times to local facilities (OR = 3.84, p = 0.004). CONCLUSION: Healthcare access in Boussemghoun is challenged by a critical lack of comprehensive care, resulting in frequent interregional healthcare mobility and a mismatch between HCU and apparently high healthcare needs. Strategic action is needed to mitigate the resulting inequalities and enhance local access to multidisciplinary quality care.

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