Disease awareness as a barrier to health service admittance. An alternative healthcare model based on population needs

Abstract

Background. Knowing how health problems are perceived is an element of primary importance for health systems, since it is the first step for the population to recognize a disease and demand medical attention. Objectives. To develop and evaluate the implementation of a new healthcare model adapted to the necessities and illness self-percep-tion of a community in the urban area of ​Greater La Plata, Buenos Aires, Argentina. Material and methods. The community’s self-rated general health status and illness self-perception were explored by a survey, fol-lowed by an intervention study performed on 2,430 participants randomly divided in 2 groups (Intervention: received personalized home health care; Control: health care was provided from hospitals and primary care health services). Results. Almost 70% of the participants were satisfied with their health status. In cases where a disease was detected; older people and men shown to perceive their illness later compared to women and young adults. Only 21% of the population had suitable access to a health service. Compared with the Control Group, regular and personalized home visits significantly improved treatment adherence (43% vs 94%), reduced annual undesirable events (stroke, myocardial infarcts, etc.) associated to chronic diseases (2.7% vs 1.2%) and lowered hospitalization rates (2.9% vs 2.0%). Conclusions. The data obtained showed that the population had low illness awareness, which reduced the spontaneous demand of care in health services. A model of health care based on regular home visits demonstrated efficacy in terms of disease prevention, illness control, avoiding consequences of chronic disease and reducing hospitalizations.