Factors Associated with Patients Bypassing Primary Health Care Facilities in Saudi Arabia: A Cross-Sectional Study

Objectives: To determine the factors associated with patients' decision to bypass primary health care (PHC) facilities and to identify respondents' reasons for such health seeking behavior Design: Descriptive, cross-sectional study Setting: Outpatient clinics in two hospitals in Riyadh city, Saudi Arabia Subjects: Eight hundred patients were administered a questionnaire to determine factors associated with bypassing PHC facilities and to explore patients' reasons for doing so Main Outcome Measures: The percentages of patients who bypassed primary health care facilities, factors associated with bypassing, and patients' perception about PHC services Results: Respondents who were young, male or had a higher level of education were more likely to bypass PHC centers. Respondents who reported having poor health status or in severe pain or hospitalized in the past 12 months were more likely to bypass PHC doctors. Negative perceptions about quality accessibility and availability of PHC services were reported as common reasons for bypassing. Conclusion: Bypassing PHC facilities is justified by the patients' health needs and their negative perceptions about quality accessibility and availability of PHC services. Patients may continue to bypass PHC facilities until health resources are made readily available for them. If bypassing behavior continues in this vein, it will markedly increase the burden on specialty clinics and adversely affect patient outcomes.