OBJECTIVES: The discomforting symptoms of minor ailments can impair quality of life for patients and interrupt their daily routine. However, improper medical seeking to emergency department (ED) or general practitioner (GP) may cause significant burden on medical expenditure and patient travel. We investigated the decision making process of the elderly engaging in minor ailment management to understand healthcare utilization in non-urban areas.

METHODS: We purposely sampled the elderly living in non-urban areas across Taiwan and held 8 focus groups. Each consisted 5-9 participants and lasted roughly 60 minutes. A semi-structured interview guide and a demographic questionnaire was developed and used. The interviews were transcribed verbatim and analyzed with grounded theory methods and peer-debriefing to generate a framework.

RESULTS: Forty-seven participates were included; 38.3 % of them are male and their average age was 67.1 years old. A framework including background factors, observation phase, and behavior phase was developed. The underlying background including internal, external and demographic factors impacted their decision making process. Once the elderly gained enough information about their body changes and minor ailments in observation phase, the overall thinking process decided their further minor ailment management in action phase. To deal with these minor conditions, most people tended to self-care with a variety of methods. If the symptoms were unsolved, they may seek advice and treatment from a range of sources including emergency department, general practitioner, community pharmacy, family and neighborhood, while others chose to ignore the illness events.

CONCLUSIONS: This framework can provide a clear information of the number of phases a patient may be in and develop individualized interventions for minor ailment management. Specifically, the underlying background show the importance of health information sharing in the non-urban community. Future research can investigate the causes of misconception and the strategies to correct improper self-care methods.