BRINGING PATIENTS TO THE COMMUNITY CLINIC: AN INTEGRATIVE REVIEW OF TREATMENT RECOMMENDATIONS, PERCEIVED VALUE, AND WILLINGNESS TO USE PRIMARY CARE SERVICES
DOI:
https://doi.org/10.35631/IJEMP.935068Keywords:
Health Information Systems, Health Service Utilisation, Perceived Value, Primary Care, Shared Decision Making, Treatment RecommendationAbstract
Community health service centres sit at the bottom of nearly every health system pyramid, yet in many countries they remain under-used by the residents they were built to serve. One underexplored lever is how treatment options are recommended. Advice that discloses the full range of feasible options and adapts to individual patients may change not only what patients know, but what they believe a community clinic can do for them. This review asks what is known about such recommendation mechanisms in community settings, how they might translate into willingness to use community care, and where the evidence stops. It draws on thirty-three theoretical and empirical sources published between 1963 and 2025, purposively selected from PubMed, Web of Science and Google Scholar, and combines four literatures that developed apart: community service utilisation, shared decision making, value in health care and consumer behaviour, and behavioural models of care seeking. Three research gaps emerge. The communication and technology traditions of medical recommendation have never been joined, and both neglect primary care. Value is measured as a system-level scorecard, while its psychological counterpart, a patient's judgement that a service will deliver worthwhile benefit, is rarely used as a mediating variable. Willingness research catalogues factors but seldom tests how service practices pass through perception into behaviour. The proposed framework links the halves: perceived disclosure and perceived tailoring are expected to raise willingness through perceived efficacy value, the belief that the centre can deliver worthwhile benefit to someone in the resident's situation, with cost perception damping the step from belief to visit. Five propositions summarise the expected relations, running from main effects through mediation to cost and health-literacy boundary conditions, and each is matched to a feasible study design. The framework gives community health service managers an audit-and-training agenda for turning better recommendation into better utilisation.
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