Healthcare Utilization Patterns for Acute Undifferentiated Febrile Illness in an Urban Slum of Delhi: A Prospective Cohort Study
Debadatta Nayak, Roja Varanasi, Rajiv Janardhanan, Simran Tandon, Sanghamitra PatiAbstract
Objective:
Acute undifferentiated febrile illness (AUFI) imposes a significant burden on individuals and the healthcare system, particularly in densely populated urban slums. In the context of rising antibiotic resistance driven by widespread self-medication and over-the-counter drug use, understanding care-seeking behavior in resource-constrained settings is essential for effective resource management and equitable public health interventions. This study examined healthcare utilization patterns among residents of an urban slum in Delhi experiencing AUFI.
Methods:
This prospective longitudinal cohort study assessed healthcare utilization patterns for AUFI using a structured interviewer-administered questionnaire over 18 months. The outcome measures were the type of healthcare facility accessed and the medical discipline consulted by individuals with AUFI episodes.
Results:
A total of 1,497 individuals were included, with 1,278 AUFI episodes recorded. Government hospitals were the most utilized (64.8%), followed by self-medication (18.9%), while private facilities had minimal use. Allopathy was the predominant medical discipline (84.7%), followed by homeopathy (6.9%), Unani (2.7%), Ayurveda (2.2%), and other unclassified practices (3.5%). Age and sex did not significantly influence healthcare choices, whereas socioeconomic status significantly affected the choice of medical discipline. The socioeconomic status was the key determinant of care-seeking behavior; while age, sex, and duration of symptoms had no significant influence.
Conclusion:
Government hospitals and allopathic treatment were the primary choices, followed by self-medication. Socioeconomic status emerged as a key determinant of care-seeking behavior.