Effect of financial services access on health services utilisation among rural older adults in Ghana

Abstract

This study explored the effect of access to financial services on rural older adults' health services utilisation. A cross‐sectional survey design was adopted to gather data (N = 310; mean age = 66.13 years and standard deviation [SD] = 24.72) in selected rural communities in Ghana. We applied endogenous treatment Poisson regression (ETPR), an econometrics model that accounts for self‐selection bias, to estimate the association between access to financial services and the use of health services. Findings revealed that education, internet use, club membership, employment status, proximity to financial institution (FI) and regional location were associated with access to financial services. Importantly, access to financial services was associated with increased health services use. The study results suggest that access to financial services may help increase the use of health services among rural older adults in Ghana.

Healthcare utilization among informal caregivers of older adults in the Ashanti region of Ghana: a study based on the health belief model

“…For instance, our analysis showed that age, education level, employment status, health insurance enrollment and self-rated health of caregivers predicted healthcare utilization. This is consistent with previous studies that have established that age [ 47 ], education [ 37 , 45 ], employment [ 93 , 94 ], health insurance enrollment [ 51 , 95 ] and self-rated health [ 76 ] are associated with healthcare utilization.…”

“…In this study, our outcome variable was healthcare utilization. Healthcare utilization was defined as seeking treatment from a formal healthcare provider (including public/private hospitals, clinics, and health centres) [ 18 , 45 – 47 , 51 , 76 ], and an informal healthcare provider (such as over-the-counter medication, salespeople, drug peddlers, traditional treatment/unlicensed practitioners, paraprofessional, and self-care treatment) [ 51 ] over the last one year preceding the survey. The one-year estimation rate of healthcare utilization in this study is consistent with earlier published works [ 45 – 47 , 51 , 77 , 78 ].…”

“…The responses were operationalized as 0 = None, 1 = Once, 2 = 2 times, 3 = 3 times, 4 = 4 times, 5 = 5 or more times. Unlike some previously published works in Ghana and elsewhere which measured healthcare utilization as a dichotomous variable [ 18 , 47 , 51 , 76 ], following Asante et al [ 45 ], Gyasi et al [ 77 ] as well as Shaffer and Nightingale [ 26 ], we measured healthcare utilization as a count variable, that is, the number of times that a participant has sought treatment for a health problem. We argue that unlike a dichotomous variable, a count variable is more likely to minimize the possibility of losing important information in the analysis while at the same time increasing the statistical rigor of the association between the dimensions of the HBM and healthcare utilization.…”

“…A health-related variable included self-rated health of caregivers (0 = very poor/poor, 1 = fair, 2 = good, 3 = very good, 4 = excellent). The inclusion of these specific control variables was informed by the existing literature on healthcare utilization and its associated factors [ 37 – 40 , 45 – 51 ]. Place of residence, gender, employment status and health insurance enrollment of caregivers were measured as dichotomous variables.…”

“…There are no known published data on the prevalence of healthcare utilization and associated factors among informal caregivers of older adults in SSA, particularly in Ghana. It is important to mention that studies on healthcare utilization that exist in Ghana have focused on the general population [ 37 – 40 ], pregnant women [ 41 – 43 ], women in general [ 44 ], as well as older adults [ 45 – 50 ] but not informal caregivers of older adults. What is known from these Ghanaian studies is that demographic, socio-economic [ 37 , 45 , 47 , 51 ], health-related [ 47 ], system (such as waiting time at the healthcare facility and healthcare costs), client preference (such as sources of funds for healthcare and sources of healthcare information) and institutional (including communication problems and level of healthcare treatment) [ 52 ] factors explain healthcare utilization.…”