Non-use of health care service among empty-nest elderly in Shandong, China: a cross-sectional study

Abstract

BackgroundEmpty-nest elderly refers to those elderly with no children or whose children have already left home. Few studies have focused on healthcare service use among empty-nest seniors, and no studies have identified the prevalence and profiles of non-use of healthcare services among empty-nest elderly. The purpose of this study is to compare the prevalence of non-use of healthcare services between empty-nest and non-empty-nest elderly and identify risk factors for the non-use of healthcare services among empty-nest seniors.MethodsFour thousand four hundred sixty nine seniors (60 years and above) were draw from a cross-sectional study conducted in three urban districts and three rural counties of Shandong Province in China. Non-visiting within the past 2 weeks and non-hospitalization in previous year are used to measure non-use of healthcare services. Chi-square test is used to compare the prevalence of non-use between empty-nesters and non-empty-nesters. Multivariate logistic regression analysis is employed to identify the risk factors of non-use among empty-nest seniors.ResultsOf 4469 respondents, 2667(59.7 %) are empty-nesters. Overall, 35.5 % of the participants had non-visiting and 34.5 % had non-hospitalization. Non-visiting rate among empty-nest elderly (37.7 %) is significantly higher than that among non-empty-nest ones (32.7 %) (P = 0.008). Non-hospitalization rate among empty-nesters (36.1 %) is slightly higher than that among non-empty-nesters (31.6 %) (P = 0.166). Financial difficulty is the leading cause for both non-visiting and non-hospitalization of the participants, and it exerts a larger negative effect on access to healthcare for empty-nest elderly than non-empty-nest ones. Both non-visiting and non-hospitalization among empty-nest seniors are independently associated with low-income households, health insurance status and non-communicable chronic diseases. The non-visiting rate is also found to be higher among the empty-nesters with lower education and those from rural areas.ConclusionsOur findings indicate that empty-nest seniors have higher non-use rate of healthcare services than non-empty-nest ones. Financial difficulty is the leading cause of non-use of health services. Healthcare policies should be developed or modified to make them more pro-poor and also pro-empty-nested.

Factors influencing healthcare use among poor older females under the Livelihood Empowerment Against Poverty programme in Atwima Nwabiagya District, Ghana

“…Similarly, illness level is noted as the most immediate factor that predicts healthcare use [19,20,35]. Consistent with previous studies in developing and developed economies, this study found a significant association between increasing number of chronic diseases and utilisation of healthcare [36][37][38][39][40]. We further found that respondents with no chronic NCDs were less likely to use healthcare [36,37].…”

“…Consistent with previous studies in developing and developed economies, this study found a significant association between increasing number of chronic diseases and utilisation of healthcare [36][37][38][39][40]. We further found that respondents with no chronic NCDs were less likely to use healthcare [36,37]. Persons who perceive themselves of being susceptible to a disease are likely to take action, and that individuals may seek intervention for a health problem based on its medical consequences [41].…”

Association of loneliness and healthcare utilization among older adults in Singapore

“…An increase of one household member was significantly associated with an increase of 0.17 visits in the past 1 month, implying that older adults in Singapore rely on their household members to visit physicians. A study from China found lower physician visits and hospitalization among empty‐nesters (older adults who have no children or whose children have left home) . Meanwhile, a positive association between depressive symptoms and the frequency of physician visits has been observed in other studies …”

Prevalence and associated factors of self-treatment behaviour among different elder subgroups in rural China: a cross-sectional study

“…The impact of family caregivers on the elders' medical decision-making has been well documented [19][20][21][22]. A study in China indicated that empty-nest seniors have a higher non-use rate of healthcare services [23]. The empty-nest effect on the elders' self-treatment remains unknown.…”

“…elders with chronic diseases, elders without chronic diseases, empty-nest elders and non-empty-nest elders). From the perspective of universal health coverage, deeper understandings of the self-treatment issue among rural elders are crucial to discovering not only the potential vulnerable groups who may be at higher risk of inequality to health service access [23], but also the service gaps [17] in the present health care system. These findings will be constructive for the improvement of the healthcare delivery system for the elderly.…”