Exploring the dimensions and internal mechanisms of perceived barriers to medical care (PBMC) among community residents.
10 affiliations
- 1The Sixth Affiliated Hospital, Kunming Medical University, Yuxi, Yunnan, China. [email protected].
- 2Department of Hematology, The 920th Hospital of Joint Logistics Support Force, Kunming, Yunnan, China. [email protected].
- 3School of General Practitioners, Kunming Medical University, Yuxi, Yunnan, China. [email protected].
- 4The First School of Clinical Medicine, Kunming Medical University, Kunming, Yunnan, China.
- 5School of General Practitioners, Kunming Medical University, Yuxi, Yunnan, China.
- 6School of Basic Medicine, Kunming Medical University, Kunming, Yunnan, China.
- 7School of Music and Dance, Qujing Normal University, Qujing, Yunnan, China.
- 8The Sixth Affiliated Hospital, Kunming Medical University, Yuxi, Yunnan, China.
- 9Yiliang County Center for Disease Control and Prevention, Zhaotong, Yunnan, China.
- 10Department of Hematology, The 920th Hospital of Joint Logistics Support Force, Kunming, Yunnan, China. [email protected].
Abstract
Background
Perceived Barriers to Medical Care (PBMC) reflect individuals' subjective psychological and behavioral obstacles during healthcare seeking, yet their structural dimensions and internal mechanisms remain insufficiently understood. This study aimed to explore the prevalence, dimensional structure, and interaction mechanisms of PBMC among community residents in Yunnan Province, Southwest China.Methods
A mixed-methods design was adopted. Semi-structured interviews were first conducted to identify manifestations of PBMC and construct the item pool. Subsequently, a cross-sectional survey involving 1,509 community residents in Yunnan Province, China, was performed between September and December 2024. Hierarchical cluster analysis (HCA), exploratory factor analysis (EFA), exploratory graph analysis (EGA), network analysis, and structural equation modeling (SEM) were applied.Results
Among respondents, 88.9% reported experiencing at least one form of PBMC. HCA, EFA, and EGA consistently identified a four-dimensional structure comprising concern, resistance, privacy, and delay. Concern mainly reflected anxiety regarding medical processes, costs, and service quality, whereas resistance represented reluctance or distrust toward medical procedures. Privacy involved concerns about personal information exposure, and delay reflected the postponement of medical consultation. Network analysis demonstrated high internal connectivity among PBMC dimensions, with resistance showing the highest centrality within the network. SEM further showed that resistance directly influenced delay and indirectly affected delay through privacy and concern (all P ＜ 0.05).Conclusions
Among community residents in Yunnan Province, Southwest China, PBMC appears to be a multidimensional and interconnected psychological-behavioral system centered on resistance. Interventions targeting resistance reduction, privacy protection, and optimization of healthcare processes may help alleviate PBMC and improve healthcare accessibility and patient experience.
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BibTeX
@article{feng2026exploring,
title = {{Exploring the dimensions and internal mechanisms of perceived barriers to medical care (PBMC) among community residents.}},
author = {Lin-Sen Feng and Yuan-Yuan Zhang and Ai Tang and Si-Rong She and Jia-Qi Xie and Rui-Jie Tang and Hao-Yu Wang and Xiao-Qian Wu and Qing Yang and Si-Tong Guo and San-Bin Wang},
journal = {Archives of public health = Archives belges de sante publique},
year = {2026},
month = aug,
doi = {10.1186/s13690-026-02040-9},
url = {https://europepmc.org/article/MED/43010106},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Exploring the dimensions and internal mechanisms of perceived barriers to medical care (PBMC) among community residents.
AU - Lin-Sen Feng
AU - Yuan-Yuan Zhang
AU - Ai Tang
AU - Si-Rong She
AU - Jia-Qi Xie
AU - Rui-Jie Tang
AU - Hao-Yu Wang
AU - Xiao-Qian Wu
AU - Qing Yang
AU - Si-Tong Guo
AU - San-Bin Wang
PY - 2026
DA - 2026/08/12
JO - Archives of public health = Archives belges de sante publique
DO - 10.1186/s13690-026-02040-9
UR - https://europepmc.org/article/MED/43010106
AB - Background Perceived Barriers to Medical Care (PBMC) reflect individuals' subjective psychological and behavioral obstacles during healthcare seeking, yet their structural dimensions and internal mechanisms remain insufficiently understood. This study aimed to explore the prevalence, dimensional structure, and interaction mechanisms of PBMC among community residents in Yunnan Province, Southwest China.Methods A mixed-methods design was adopted. Semi-structured interviews were first conducted to identify manifestations of PBMC and construct the item pool. Subsequently, a cross-sectional survey involving 1,509 community residents in Yunnan Province, China, was performed between September and December 2024. Hierarchical cluster analysis (HCA), exploratory factor analysis (EFA), exploratory graph analysis (EGA), network analysis, and structural equation modeling (SEM) were applied.Results Among respondents, 88.9% reported experiencing at least one form of PBMC. HCA, EFA, and EGA consistently identified a four-dimensional structure comprising concern, resistance, privacy, and delay. Concern mainly reflected anxiety regarding medical processes, costs, and service quality, whereas resistance represented reluctance or distrust toward medical procedures. Privacy involved concerns about personal information exposure, and delay reflected the postponement of medical consultation. Network analysis demonstrated high internal connectivity among PBMC dimensions, with resistance showing the highest centrality within the network. SEM further showed that resistance directly influenced delay and indirectly affected delay through privacy and concern (all P ＜ 0.05).Conclusions Among community residents in Yunnan Province, Southwest China, PBMC appears to be a multidimensional and interconnected psychological-behavioral system centered on resistance. Interventions targeting resistance reduction, privacy protection, and optimization of healthcare processes may help alleviate PBMC and improve healthcare accessibility and patient experience.
SN - 0778-7367
SN - 2049-3258
ER -