Healthcare Utilization Patterns for Acute Undifferentiated Febrile Illness in an Urban Slum of Delhi: A Prospective Cohort Study.

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.