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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1503601
This article is part of the Research Topic Public Health Outcomes: The Role of Social Security Systems in Improving Residents' Health Welfare View all 18 articles
Factors Influencing Intentional Non-Utilization of Healthcare: A Study Using the Andersen Model
Provisionally accepted- 1 Xuzhou Medical University, Xuzhou, China
- 2 Chongqing Medical University, Chongqing, China
- 3 Jilin University, Changchun, Hebei Province, China
Objective: This study aims to investigate the factors influencing residents' healthcare utilization behavior and provide a scientific basis for enhancing the overall efficiency of healthcare utilization.A comprehensive analysis was conducted using data from the China General Social Survey (CGSS) project. Exploratory Factor Analysis (EFA) and Structural Equation Modeling (SEM) were utilized to examine the influences and interrelationships of the three core factors of the Andersen Healthcare Utilization Model (Predisposing Factors, Enabling Resources, and Need), as well as the two extended factors (health behaviors and Medical-service Experience), on residents' decisions regarding the utilization of healthcare services.Results: A total of 2230 participants were enrolled in this study. Most were male (55.74%), were married (85.38%), and had junior-and senior-high school educations (45.29%). Mean age was 52.39 years, and 56.32% of participants reported an annual income of <30,000 RMB. EFA distilled influencing factors into four domains:Predisposing and Enabling, Need, Health Behaviors, and Medical-service Experience.The results of the revised SEM indicated that the influence coefficients of Predisposing and Enabling, Need, and Medical-service Experience on Decision to Utilize Health Services (DUHS) were 0.095, -0.104, and 0.093 respectively.Enabling, Need, and Health Behaviors on DUHS were -0.098, 0.024, and -0.017, respectively, all of which were statistically significant. Finally, the fit indices of the modified model indicated an acceptable model fit.This study showed that unmarried individuals with lower income and job instability exhibit reduced healthcare utilization due to economic barriers and lack of social support. Furthermore, medical service experience is another crucial factor affecting health service utilization. Notably, our findings suggest the need for targeted interventions, including enhanced insurance coverage, improving the quality of medical services and health education campaigns to mitigate disparities in access to health services.
Keywords: Medical services, Andersen healthcare utilization model, National survey, Influencing factors, structural equation model
Received: 29 Sep 2024; Accepted: 24 Mar 2025.
Copyright: © 2025 JIa, Miao, Song, Feng and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huanhuan JIa, Xuzhou Medical University, Xuzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.