What factors are associated with utilisation of health services for the poor elderly? Evidence from a nationally representative longitudinal survey in China
Abstract:ObjectivesTo investigate the status and factors of healthcare service utilisation among the poor elderly in China.MethodsWe selected the poor elderly from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. The main outcome measures include utilisation indicators for the probability and costs of outpatient/inpatient services. Based on modified Andersen behaviour model, a two-part model is designed to analyse the factors of the health service utilisation of the poor elderly.ResultsThe… Show more
“…A study done in China has reported a crucial role of the need factor in determining health service utilization among the elderly. This same study has reported financial difficulties as a barrier and education, having social security and poor health status as a facilitator to use health services [ 56 ]. Similar to our finding, a study done in India among the elderly has found health care utilization to increase significantly with multimorbidity [ 57 ].…”
Background
Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. In the ageing population, health problems, and health care utilization should be assessed carefully and addressed. This study aimed to identify chronic morbidities, health problems, health care seeking behaviour and health care utilization among the elderly.
Methods
We conducted a community based, cross-sectional study in urban areas of the Sunsari district using face-to-face interviews. A total of 530 elderly participants were interviewed and selected by a simple proportionate random sampling technique.
Results
About half, 48.3%, elderly were suffering from pre-existing chronic morbidities, of which, 30.9% had single morbidity, and 17.4% had multi-morbidities. This study unfurled more than 50.0% prevalence of health ailments like circulatory, digestive, eye, musculoskeletal and psychological problems each representing the burden of 68.7%, 68.3%, 66.2%, 65.8% and 55.7% respectively. Our study also found that 58.7% preferred hospitals as their first contact facility. Despite the preferences, 46.0% reported visiting traditional healers for treatment of their ailments. About 68.1% reported having difficulty seeking health care and 51.1% reported visits to a health care facility within the last 6 months period. The participants with pre-existing morbidity, health insurance, and an economic status above the poverty line were more likely to visit health care facilities.
Conclusion
Elderly people had a higher prevalence of health ailments, but unsatisfactory health care seeking and health care utilization behaviour. These need further investigation and attention by the public health system in order to provide appropriate curative and preventive health care to the elderly. There is an urgent need to promote geriatric health services and make them available at the primary health care level, the first level of contact with a national health system.
“…A study done in China has reported a crucial role of the need factor in determining health service utilization among the elderly. This same study has reported financial difficulties as a barrier and education, having social security and poor health status as a facilitator to use health services [ 56 ]. Similar to our finding, a study done in India among the elderly has found health care utilization to increase significantly with multimorbidity [ 57 ].…”
Background
Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. In the ageing population, health problems, and health care utilization should be assessed carefully and addressed. This study aimed to identify chronic morbidities, health problems, health care seeking behaviour and health care utilization among the elderly.
Methods
We conducted a community based, cross-sectional study in urban areas of the Sunsari district using face-to-face interviews. A total of 530 elderly participants were interviewed and selected by a simple proportionate random sampling technique.
Results
About half, 48.3%, elderly were suffering from pre-existing chronic morbidities, of which, 30.9% had single morbidity, and 17.4% had multi-morbidities. This study unfurled more than 50.0% prevalence of health ailments like circulatory, digestive, eye, musculoskeletal and psychological problems each representing the burden of 68.7%, 68.3%, 66.2%, 65.8% and 55.7% respectively. Our study also found that 58.7% preferred hospitals as their first contact facility. Despite the preferences, 46.0% reported visiting traditional healers for treatment of their ailments. About 68.1% reported having difficulty seeking health care and 51.1% reported visits to a health care facility within the last 6 months period. The participants with pre-existing morbidity, health insurance, and an economic status above the poverty line were more likely to visit health care facilities.
Conclusion
Elderly people had a higher prevalence of health ailments, but unsatisfactory health care seeking and health care utilization behaviour. These need further investigation and attention by the public health system in order to provide appropriate curative and preventive health care to the elderly. There is an urgent need to promote geriatric health services and make them available at the primary health care level, the first level of contact with a national health system.
“…To analyze the difference in the relationship between air quality and health shocks, heterogeneity tests were conducted based on age, gender, and regional groups. According to the division of age from Hu et al ( 11 ) and Zeng et al ( 37 ), our samples were divided into 60–69 and 70+ years (we classified these two groups as “young-older” and “older,” respectively. The gender groups were divided into male samples and female samples.…”
Section: Resultsmentioning
confidence: 99%
“…Referring to Grossman's health needs theory and Zeng et al ( 37 ) regarding the delineation of control variables, and modified to fit the needs of the study, the individual control variables were divided into three categories: demographic characteristics, enabling variables, and social welfare ( 36 , 37 ). Demographic characteristics included sex, age, marital status, education level, and type of residence.…”
MethodsWe selected 5,172 microdata on individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2018. The binary logit model, the ordered logit model, and the stepwise regression were employed to compare the effects of air pollution on self-rated health (SRH) and activities of daily living (ADL) in an elderly population. The effects on health shocks were explored in different age groups, different gender groups, different regions and different sources of pollutants, respectively.ResultsWe found that air pollution significantly increased the risk of health shocks in the elderly population, especially in the 60–69 year age group, and the eastern/central region, where NO2 and O3 were important pollutant sources.ConclusionTargeted management of the environment is necessary to improve the health status of China's elderly population. In addition, paying attention to the health status of vulnerable populations is needed to achieve social equity.
“…[48] In addition, based on the population from CHARLS, the low-literacy older adults were less likely to search for health services. [49] So, relevant strategies on internet education and health literacy promotion to encourage effective internet access should be underscored in developed and developing countries.…”
Background
With increasing trend of internet use in all age groups, whether internet use can prevent frailty in middle-aged and older adults remains unclear.
Methods
Five cohorts across the United States, England, 28 Europe countries, China and Mexico were used in this study. Frailty status was assessed by frailty index based on a standard procedure. Generalized estimating equations models, random effects meta-analysis, and mediation analysis were utilized.
Results
In the multicohort study, a total of 155,695 participants were included. The proportion of internet use was varied across countries, ranging from 5.56% in China to 83.46% in Denmark. According to the generalized estimating equations models and meta-analysis, internet use was inversely associated with frailty, with the pooled ORs (95%CIs) of 0.72 (0.67,0.79). Additionally, the association was partially mediated by social activities and slightly pronounced in participants aged 65 and over, male, not working for payment, not married or partnered, not smoking, drinking, and not co-residence with children.
Conclusions
Our findings highlight the important role of internet use in the incidence of frailty and recommend more engagements in social activities among middle-aged and older adults. Grasping the opportunity to spread health information and increase social activities by the internet would decrease the incidence of frailty.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.