Healthcare utilization for diabetes and its associated factors: A survey study in Tehran, the capital of Iran

Background and objective: The design and improvement of healthcare services related to diabetes require assessing the utilization of these services. The aim of this study was to assess healthcare utilization for diabetes and its associated factors in Tehran. Methods The present study is a cross-sectional, descriptive-analytical study conducted among 4500 adult residents (≥ 30 years old) of Tehran, the capital city of Iran, via a stratified random sampling method. A telephone survey was conducted in 22 districts of Tehran, and individuals were asked about their utilization of diabetes-related health services. Individuals were also asked about their reasons for receiving or not receiving services and associated factors. Data analysis was performed via Stata software version 18, with a confidence level of 95%. Results Out of a total of 4,500 participants, 12.2% reported having used services related to diabetes at a healthcare facility within the past two years. The most common locations for receiving the last diabetes-related services were private specialist physicians’ offices (33.8%). The most frequently reported reasons for service utilization were ensuring the safety of the service (72.4%) and “High professional level of the physician/health care provider in terms of knowledge, education, and quality of medical advice” (62.7%). Among the reasons cited by participants who did not utilize services, the most frequently mentioned were financial problems and a lack of service fees (80.9). Age over sixty years, being female, having a higher education level, having better socioeconomic status and self-reported health, having armed forces insurance, being married, being retired, having supplementary insurance, and having diabetes were significantly associated with greater utilization of diabetes-related health services (p < 0.05). Conclusion Despite the alarming increase in the incidence of diabetes in the country, the utilization of health services in Tehran may not be desirable. Tehran, with a population of more than 9 million people, accounts for approximately 10% of the country's population, and access to services should not necessarily be considered the ultimate utilization of people from services. Adequate education and awareness of diabetes, increasing the financial capacity of people to refer for services, and reforming health service packages with the aim of improving the quality, attractiveness, and effectiveness of services can be created with proper health policy planning and decisions. With appropriate technology, accessible health services can be utilized by people.