Determinants of primary healthcare centers utilization: A geo-statistical study of healthcare access in Madurai district, Tamil Nadu

Health services play a pivotal role in shaping social well-being and community development. This study evaluates the performance of Primary Health Centres (PHCs) in Madurai District, Tamil Nadu, through a comprehensive spatial and statistical assessment of healthcare accessibility and utilisation patterns. A mixed-method approach integrating GIS-based spatial analysis, statistical modelling, and survey data from local populations was employed to understand the disparities in healthcare access. Key techniques include Kernel Density Estimation, Moran’s I spatial autocorrelation, factor analysis, and regression analysis. The results identified thirteen key factors, with 'Patient Access to PHC' emerging as the primary determinant influencing healthcare utilisation. Significant correlations were observed between socio-economic conditions, disease burden, and healthcare infrastructure. The spatial distribution map revealed notable urban-rural disparities in PHC accessibility. The study underscores the importance of enhancing healthcare infrastructure, economic affordability, and public awareness. The findings provide critical insights for policymakers to develop equitable and sustainable healthcare delivery systems.