Access and utilization of public and private Primary Health Care among adults and elderly people with chronic condition(s) in Albania

The burden of disease due to Non-Communicable Diseases (NCDs) is globally on the rise. Primary Health Care (PHC) services can contribute to NCD control and hold an important role. This dissertation provides insights into patient access and the perceived quality of care among 23 public and five private providers in two regions of Albania. Additionally, healthcare-seeking behaviors and Out-of-Pocket payment of the population suffering from NCDs were investigated through a household survey among nearly 1000 chronically ill. The findings show that users of public and private providers have similar views on the quality of non-clinical care. However, prompt attention and coordination of care need additional improvement. While most elderly people visited a PHC to initiate treatment (and follow-up) of their chronic conditions, adults (aged 18–59) initiated and sought regular NCD care at a hospital level through self-referral, bypassing PHC services. Out-of-pocket payments by NCD patients remain important and relate principally to purchasing prescribed drugs. Fostering the health literacy of patients and caregivers in NCD prevention, management, and control through the PHC level is essential, along with establishing well-structured referral mechanisms. Active engagement of local decision-makers is needed.