Evidence map›Paper›PMID 40849474›Full record

ArticleBMC health services research2025

Ecology of healthcare in an urban and rural area of Gampaha district of Sri Lanka: a community-based prospective study on symptom prevalence and healthcare utilization.

S S Withana, K Mendis, U P Liyanage, S Nandasena, A R Wickremasinghe

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Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

S S WithanaDepartment of Family Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
K MendisDepartment of Primary Care and Family Medicine, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, P.O. Box 02, Belihuloya, Sri Lanka.
U P LiyanageDepartment of Statistics and Computer Science, Faculty of Science, University of Kelaniya, Kelaniya, Sri Lanka (Formerly) and University of Colombo, Colombo, Sri Lanka.
S NandasenaDeputy Regional Director of Health Services, Office of the Regional Director of Health Services, Kalutara, Sri Lanka.
A R WickremasingheDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. arwicks@kln.ac.lk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 55 million visits to government outpatient departments (OPD) in Sri Lanka in 2014, is estimated to increase to 100 million in 2027. The private OPD visits in 2014 was estimated at 50 million per annum. In primary care, there is a paucity of medical records, research on symptoms and healthcare seeking behaviour. We aimed to determine the symptom prevalence and healthcare seeking pattern of residents in Gampaha district, Sri Lanka.

methodsA community-based prospective study using a participant-held symptom diary and interviews were conducted in two areas, Ragama (urban) and Mirigama (rural), in the Gampaha district of Sri Lanka during May-June 2018. For each area, three midwife areas were randomly chosen. Clusters of 15-20 households were selected from 5-6 random locations from each midwife area.

results2046 individuals from 557 households participated. Majority were females (n = 1127, 55.1%). There were 1207 (59%) from Mirigama area. Among participants, 1919 (93.8%) reported symptoms. Phlegm (n = 4200, 7.0%), leg pain (n = 3943, 6.6%) and cough (n = 3153, 5.3%) were top symptoms among all symptoms reported; the musculoskeletal group (n = 18,081, 30.4%) predominated. 924 (45.1%) participants sought treatment, 763 out of 2046 participants (37.3%) sought allopathic treatment. Private sector visits were more (n = 515, 25.2%). The decision to seek private or public healthcare services was influenced by income. Persons with higher income preferred a private institution. Of the 46 (2.3%) hospital admissions, 42 (91.3%) were to public hospitals, of which, 19 (41.3%) were to teaching hospitals, and 4 (0.9%) to a private institution.

conclusionsThe population had a high prevalence of symptom reporting (93.8%) and a high healthcare seeking behaviour (45.2%). Among those who sought allopathic treatment, the majority preferred private ambulatory care. 90% of hospital admissions (42/47) were to public hospitals. Provision of ambulatory care services should be prioritized in further development of the health services.

Indexed as

Patient Acceptance of Health CareRural PopulationUrban PopulationAdolescentAdultAgedFemaleHumansMaleMiddle AgedPrevalenceProspective StudiesSri LankaYoung AdultEcology of healthcareHealthcare seeking behaviourMorbiditySri LankaSymptom prevalence

Identifiers

PMID40849474
PMCPMC12375270

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