The Effect of Sociodemographic, Socioeconomic, and Health Factors on Healthcare Utilization in Cardiovascular Patients in Serbia: A Part of National Health Survey

Tamara Lekovic^1,2*Nikoleta Janicijevic^3*Milos Potezica²Nela Djonovic^1,3Dragan Vasiljevic³Katarina Mirjana Janicijevic⁴Melanija Tepavcevic⁵Snezana Knezevic⁶Jelena Vuckovic Filipovic^7,8Amela Rastoder Celebic⁹Svetlana Vukosavljevic¹⁰Maja Mirocevic Rotolo¹¹Dalibor Stajic³

• ¹Department of Hygiene and Ecology, Institute of public health Kragujevac, Kragujevac, Serbia
• ²Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ³Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ⁴Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ⁵Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ⁶Department of Medical Sciences, Academy of Applied Studies Polytechnic, Belgrade, Serbia
• ⁷Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ⁸Clinic for Cardiology, University Clinical Center Kragujevac, Kragujevac, Sumadija and Western Serbia, Serbia
• ⁹Health Center Niksic, Niksic, Montenegro
• ¹⁰Health Center Dimitrije Pitovic, Kosjeric, Serbia
• ¹¹A3 Medical Montenegro, Sutomore, Montenegro

Objectives: This cross-sectional analytical study explores the predictors of the healthcare utilization in the adult population with cardiovascular diseases; Methodology: The research was carried out as part of the fourth Serbian National Health Survey, in the period from October to December 2019, as a descriptive, cross-sectional analytical study and included the population of cardiovascular patients (N=4712) aged over 20 years; Descriptive and inferential statistical methods, including percentage-based structure indicators, Chi-square (χ2) tests for categorical variable differences, and logistic regression for examining relationships between dependent and independent variables, were used in the data analysis. Results: The analysis identified several significant contributors to cardiovascular healthcare utilization, emphasizing distinct and overlapping factors that impact various types of healthcare use. The chi-square test has shown that predominantly, each form of healthcare utilization is most prevalent among the 60-69 age group (general practitioner visits: 33.9%, specialist visits: 33.1%, hospitalization: 31.4%, p<0.001 Self-assessment of general health (bad/very bad) and the presence of multiple chronic conditions were positively associated with general practitioner (PR=1.037(1.001-1.075);p=0.044, PR=1.077(1.039-1.117);p<0.001), specialist visits (PR=1.381(1.281-1.490);p<0.001, PR=1.279(1.181-1.385);p<0.001) and hospitalization p<0.001, p<0.001).Sociodemographic factors and some aspects of health status have a significant impact on the cardiovascular healthcare, thereby precise recommendations for facilitating appropriate healthcare utilization should be established. A top priority for academics, physicians and public health specialists is to keep emphasizing the significance of socio-demographic determinants in lowering cardiovascular complications, as well as strengthening cardiovascular healthcare.