Effects of economic recession on elderly patients’ perceptions of access to health care and medicines in Portugal

Abstract

Background In view of the current financial and demographic situation in Portugal, accessibility to health care may be affected, including the ability to adhere to medication. Objective To evaluate the perceived effects of the crisis on elderly patient's access to medicines and medical care, and its implications on medicine-taking behaviour. Setting Community pharmacy. Method A cross-sectional study was undertaken during April 2013, where elderly patients answered a self-administered questionnaire based on their health-related experiences in the current and previous year. Binary logistic regression was used to ascertain the effects of potential predictors on the likelihood of adherence. Main outcome measures self-reported adherence. Results A total of 1231 questionnaires were collected. 27.3% of patients had stopped using treatments or health services in the previous year for financial motives; mostly private medical appointments, followed by dentist appointments. Almost 30% of patients stopped purchasing prescribed medicines. Over 20% of patients reduced their use of public services. Out-of-pocket expenses with medicines were considered higher in the current year by 40.1% of patients. The most common strategy developed to cope with increasing costs of medicines was generic substitution, but around 15% of patients also stopped taking their medication or started saving by increasing the interdose interval. Conclusion Reports of decreasing costs with medicines was associated with a decreased likelihood of adherence (OR 0.42; 95% CI 0.27-0.65). Lower perceived health status and having 3 or more co-morbidities were associated with lower odds of adhering, whilst less frequent medical appointments was associated with a higher likelihood of exhibiting adherence.

Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries

“…Within the Dutch focus groups, for example, a considerable level of uncertainty was expressed by the participants due to the forthcoming legal changes and expected financial cuts [ 49 ]. The economic austerity faced in IE and PT may have increased the negative expectations of available services [ 50 , 51 ], while the current legal changes in DE are likely to improve the situation of people with dementia and their families [ 52 ].…”

Time trends in antibiotic consumption in the elderly: Ten-year follow-up of the Spanish National Health Survey and the European Health Interview Survey for Spain (2003–2014)

“…We observed a variation in prevalence in 2009, probably because the purchasing power of elderly persons decreased during the economic recession and prescriptions were more closely controlled, thus potentially leading to misuse of medication [ 27 , 28 ].…”

Modeling the influence of social ties and transportation choice on access to oral healthcare for older adults

“…Inequities in oral healthcare access are exacerbated for older adults upon retirement and subsequent loss of employer-sponsored oral healthcare coverage. These injustices are then compounded by difficulties in conducting daily activities and navigating the built environment due to chronic diseases and disabilities, the inability to afford out-of-pocket expenses required by most private and public health insurance plans, and discriminatory treatment when they do visit healthcare providers (Park, 2009; Andersen, 1995; da Costa, et al, 2017).…”