Socioeconomic determinants of access to health services among older adults: a systematic review

Abstract

OBJECTIVE The objective of this study was to analyze the association between the socioeconomic characteristics and the access to or use of health services among older adults.METHODS This is a systematic review of the literature. The search has been carried out in the databases PubMed, LILACS and Web of Science, without restriction of dates and languages; however we have included only articles published in Portuguese, English, and Spanish. The inclusion criteria were: observational design, socioeconomic factors as variables of interest in the analysis of the access to or use of health services among older adults, representative sample of the target population, adjustment for confounding factors, and no selection bias.RESULTS We have found 5,096 articles after deleting duplicates and 36 of them have been selected for review after the process of reading and evaluating the inclusion criteria. Higher income and education have been associated with the use and access to medical appointments in developing countries and some developed countries. The same association has been observed in dental appointments in all countries. Most studies have shown no association between socioeconomic characteristics and the use of inpatient and emergency services. We have identified greater use of home visits in lower-income individuals, with the exception of the United States.CONCLUSIONS We have observed an unequal access to or use of health services in most countries, varying according to the type of service used. The expansion of the health care coverage is necessary to reduce this unequal access generated by social inequities.

Procura por serviços ou profissionais de saúde entre adolescentes brasileiros, segundo a Pesquisa Nacional de Saúde do Escolar de 2015

“…Data from the National Household Sample Survey (PNAD) indicate an increase in the use of health services and point to a reduction in the inequalities of access to primary health care [29][30] , but such inequalities persist, mainly in relation to income. These differences may relate the demand for care, which is higher among people with lower income [31][32][33][34] .…”

Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana

“…Factors that predict such healthcare utilisation include health insurance status [19], education, gender [16,19], age, social status, marital status, ethnicity, religion, family size, employment and type of occupation [16]. Empirical evidence has shown that demographic, socio-economic [20,21] and health status factors [22][23][24], are associated with formal healthcare utilisation among older people.…”

Predictors of having a dentist among older adults in Iowa

“…Other systemic conditions, such as cognitive decline and peripheral arterial disease, as well as overall mortality, have been linked to tooth loss. Financial limitations have also been linked to reduced oral healthcare utilization among older adults in multiple countries, and increased oral health insurance coverage is associated with higher use of oral healthcare services …”