Effect of socio-economic factors in utilization of different healthcare services among older adult men and women in Ghana

Abstract

BackgroundThe older adult population is increasing all over the world. In sub-Saharan Africa, due to poverty and low policy coverage, older adults are not well catered for. The effect of socio-economic inequality in the use of healthcare services among older adult men and women in Ghana was investigated in this paper.MethodsThe data employed in the study were drawn from Global Ageing and Adult Health survey SAGE Wave 1 Ghana and was based on the design for the World Health Survey 2003, SAGE Wave 0, Ghana. The survey was conducted in 2007–2008 and collected data on socio-economic characteristics and other variables of the 5573 individuals interviewed.ResultsUsing generalized logit model, the study found that health status is a very strong determinant of the type of healthcare services preferred by older adults Ghanaians. Men with higher income preferred the private health facilities, while those who completed tertiary education, those with health insurance and those who self-rated their health as very bad, bad or moderate preferred public facility. Self-employed men and those in informal employment, preferred other health facilities outside the formal public health service. Women with primary and secondary education, preferred the private health facilities. Women with health insurance, those in middle and upper class income quintiles or those with self-rated bad and moderate health status or being relatively younger preferred the public facility to other health services. Self-employed women and those in informal employment preferred traditional treatment. In Ghana, there are important socio-economic gradients in the use of some healthcare services. In both sexes, those without insurance and rural residents preferred the pharmacy and traditional treatment.ConclusionThese differences may be due to socio-economic inequities but could also indicate that the existing health facilities are not always used in an optimal way. Patient factors may be equally important as supply factors in explaining the differential use of health services. The public health systems in Ghana still have a major role in improving the health of older adults. National commitments in providing basic essential infrastructure and personnel to health centres for the citizenry is imperative. Policy readjustment of the national health insurance scheme to make it truly accessible to the aged is essential.

Economic Analysis of Health Inequality Among the Elderly in Ghana

“…However, despite these concurrent findings, a cross country study in six countries found that hypertension was more prevalent among rich elderly Ghanaians (Stringhini et al 2016). This could be attributed to easy access to healthcare and hence higher chances of being aware of health status or better still, high consumption of fatladen diets as well as sedentary lifestyle (Saeed et al 2016). This finding implies that self-report status as a measure of wellbeing could be prone to some bias.…”

“…Our study focuses on the elderly in Ghana because they have been neglected in terms of health interventions (de-Graft Aikins 2007). Previous studies have measured socioeconomic inequality in access to healthcare and found that the poor had limited access to healthcare services in Ghana (Saeed et al 2016). Another study showed that NCDs were more prevalent among rich elderly persons in Ghana (Kunna et al 2017).…”

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.…”

Behavioral factors associated with utilization of outpatient services among elderly in Pakistan: evidence from a nationally representative survey

“…As stated in the study, heavy reliance on less quali ed or unskilled health workers in private facilities, poor people spend a greater proportion of their income on healthcare than the rich [39]. An opposing nding was reported by a study conducted in Ghana showing a positive association between wealth and the use of private facilities [33]. A study conducted in Hong Kong also reported that poor elders were more likely to utilize public facilities and fewer private service providers [27].…”

“…A higher level of education and better economic status are interrelated to each other and can be taken as a proxy measure of affordability as chances are high that educated individuals get a job that pays well which enables them to pay healthcare costs in private hospitals. A study also reported that not having education was associated with higher utilization of healthcare at PHC [26], while another study revealed that some level of education was associated with utilization of health services in private facilities [33].…”