Does having a family physician influence health seeking behavior and referral pattern in urban India: A cross-sectional analysis

<h2>Abstract</h2><h3>Problem considered</h3> In absence of a structured referral system, family physicians play a critical role in offering continuous, personalized care. Since consulting a family physician is uncommon even in urban areas, this study examines how family physicians influence health-seeking behavior and referral patterns in urban India. <h3>Methods</h3> A cross-sectional survey has been conducted with 254 participants (21-60 years) in urban Bengaluru, Karnataka, using a structured questionnaire both from slum and non-slum population. Bi-variate and multivariate analysis are conducted to evaluate the association of having a family physician with health-seeking behavior and referral patterns as experienced by the respondents. <h3>Results</h3> Educated, well-off, and non-slum respondents reported having a family physician. Respondents with a family physician reported fewer in-person consultations and lower hospitalization rates compared to those without. However, this relationship lost statistical significance after adjusting for background variables. The likelihood of not availing an online consultation was 70% lower among respondents without a family physician. During emergency decision-making, those with a family physician relied less on family members (OR=0.36). Respondents with a family physician experienced three times higher private-to-private referral and 70% lower public-to-public movement. <h3>Conclusion</h3> The presence of a family physician is associated with distinct patterns in physical and online consultations, hospitalization, and referral practices in urban India. Utilization of family physicians is socio-economically diverse; hence, formally integrating primary caregivers within the system may contribute to more equitable healthcare and reduced reliance on tertiary services, especially among urban poor.