PREDICTING TREATMENT-SEEKING BEHAVIOR IN GUATEMALA - A COMPARISON OF THE HEALTH-SERVICES RESEARCH AND DECISION-THEORETIC APPROACHES

This study attempts to identify and describe factors associated with t he choice of a health care source in rural Guatemala. Because of limit ed choice options, rural Guatemala makes an excellent location for stu dying the factors that affect utilization patterns. Illness case histo ries were collected from a random sample of 270 households in six vill ages. Then, two different methodological approaches were used to predi ct treatment actions. First, a sociobehavioral model, which encompasse s enabling, predisposing, and need factors, was used to predict treatm ent choices. Using discriminant analysis we identified factors associa ted with the use of home remedies, a pharmacy, the health post, a phys ician, or folk healer. In a second, parallel study, descriptive interv iews were used to identify important factors in choosing a treatment s trategy. From these interviews, and from responses to hypothetical ill ness cases, we developed a decision model of treatment actions. Both m odels were tested against the set of illness cases. Results indicate t hat both approaches identify similar variables (especially, severity), although selection of variables through the multivariate analysis was much more successful in predicting treatment actions.