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The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India

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Abstract
Background: Chronic conditions are on rise globally and in India. Prevailing intra-urban inequities in access to healthcare services compounds the problems faced by urban poor. This paper reports the trends in self-reported prevalence of chronic conditions and health-seeking pattern among residents of a poor urban neighborhood in south India. Methods: A cross sectional survey of 1099 households (5340 individuals) was conducted using a structured questionnaire. The prevalence and health-seeking pattern for chronic conditions in general and for hypertension and diabetes in particular were assessed and compared with a survey conducted in the same community three years ago. The predictors of prevalence and health-seeking pattern were analyzed through a multivariable logistic regression analysis. Results: The overall self-reported prevalence of chronic conditions was 12 %, with hypertension (7 %) and diabetes (5.8 %) being the common conditions. The self-reported prevalence of chronic conditions increased by 3.8 percentage point over a period of three years (OR: 1.5). Older people, women and people living below the poverty line had greater odds of having chronic conditions across the two studies compared. Majority of patients (89.3 %) sought care from private health facilities indicating a decrease by 8.7 percentage points in use of government health facility compared to the earlier study (OR: 0.5). Patients seeking care from super specialty hospitals and those living below the poverty line were more likely to seek care from government health facilities. Conclusion: There is need to strengthen health services with a preferential focus on government services to assure affordable care for chronic conditions to urban poor.
Keywords
IMPAIRED GLUCOSE-TOLERANCE, slum, poverty, India, health system, health service, diabetes, non-communicable diseases, chronic condition, chronic diseases, PROBLEMATIC DISCOURSE, CARDIOVASCULAR HEALTH, SOCIOECONOMIC-STATUS, DISEASES, PREVALENCE, GUN

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Chicago
Gowda, Mrunalini J, Upendra Bhojani, Narayanan Devadasan, and Thriveni S Beerenahally. 2015. “The Rising Burden of Chronic Conditions Among Urban Poor: a Three-year Follow-up Survey in Bengaluru, India.” Bmc Health Services Research 15.
APA
Gowda, M. J., Bhojani, U., Devadasan, N., & Beerenahally, T. S. (2015). The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India. BMC HEALTH SERVICES RESEARCH, 15.
Vancouver
1.
Gowda MJ, Bhojani U, Devadasan N, Beerenahally TS. The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India. BMC HEALTH SERVICES RESEARCH. 2015;15.
MLA
Gowda, Mrunalini J, Upendra Bhojani, Narayanan Devadasan, et al. “The Rising Burden of Chronic Conditions Among Urban Poor: a Three-year Follow-up Survey in Bengaluru, India.” BMC HEALTH SERVICES RESEARCH 15 (2015): n. pag. Print.
@article{6931842,
  abstract     = {Background: Chronic conditions are on rise globally and in India. Prevailing intra-urban inequities in access to healthcare services compounds the problems faced by urban poor. This paper reports the trends in self-reported prevalence of chronic conditions and health-seeking pattern among residents of a poor urban neighborhood in south India. 
Methods: A cross sectional survey of 1099 households (5340 individuals) was conducted using a structured questionnaire. The prevalence and health-seeking pattern for chronic conditions in general and for hypertension and diabetes in particular were assessed and compared with a survey conducted in the same community three years ago. The predictors of prevalence and health-seeking pattern were analyzed through a multivariable logistic regression analysis. 
Results: The overall self-reported prevalence of chronic conditions was 12 \%, with hypertension (7 \%) and diabetes (5.8 \%) being the common conditions. The self-reported prevalence of chronic conditions increased by 3.8 percentage point over a period of three years (OR: 1.5). Older people, women and people living below the poverty line had greater odds of having chronic conditions across the two studies compared. Majority of patients (89.3 \%) sought care from private health facilities indicating a decrease by 8.7 percentage points in use of government health facility compared to the earlier study (OR: 0.5). Patients seeking care from super specialty hospitals and those living below the poverty line were more likely to seek care from government health facilities. 
Conclusion: There is need to strengthen health services with a preferential focus on government services to assure affordable care for chronic conditions to urban poor.},
  articleno    = {330},
  author       = {Gowda, Mrunalini J and Bhojani, Upendra and Devadasan, Narayanan and Beerenahally, Thriveni S},
  issn         = {1472-6963},
  journal      = {BMC HEALTH SERVICES RESEARCH},
  keyword      = {IMPAIRED GLUCOSE-TOLERANCE,slum,poverty,India,health system,health service,diabetes,non-communicable diseases,chronic condition,chronic diseases,PROBLEMATIC DISCOURSE,CARDIOVASCULAR HEALTH,SOCIOECONOMIC-STATUS,DISEASES,PREVALENCE,GUN},
  language     = {eng},
  pages        = {8},
  title        = {The rising burden of chronic conditions among urban poor: a three-year follow-up survey in Bengaluru, India},
  url          = {http://dx.doi.org/10.1186/s12913-015-0999-5},
  volume       = {15},
  year         = {2015},
}

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