Utilization of Healthcare Services by the Elderly Patients at Korle-Bu Teaching Hospital, Accra
Keywords:elderly, healthcare, utilization
Objective: The study assessed the association between predisposing, enabling and need factors on utilization of healthcare services by the elderly attending the Korle-Bu Teaching Hospital.
Methods: The study was a descriptive cross-sectional survey using a mixed method approach. Simple random sampling was used to sample three hundred and sixty-one elderly patients from seven (7) Out-Patient Departments in the Korle-Bu Teaching Hospital who responded to a structured questionnaire. Ordinal Logistic Regression was used to determine the association between the predisposing, enabling and need factors of the elderly and variables measuring utilization of healthcare. In the qualitative study, purposive and convenient samplings were used to select 76 elderly persons from the seven Out-Patient Departments of the hospital. Content analysis was used to analyze the voice recorded qualitative interview data and explained using an appropriate theory.
Quantitative findings: The elderly who obtained above secondary school education were 0.49 times less likely to rate accessibility of healthcare on a higher scale compared with the elderly with pre-secondary education (OR=0.49, 95% CL; 0.28-0.85, p=0.11). The elderly who were beneficiaries of NHI were 0.42 times less likely (OR=0.42, 95% CI; 0.18-0.97) to rate accessibility of healthcare services on a higher scale compared with the elderly who were non-beneficiaries (p=0.042).
The elderly with multiple chronic conditions were 1.56 times more likely to rate the cost of healthcare on a higher scale compared with the elderly with one chronic condition (OR=1.56, 95% CI=1.04-2.34, p=0.03).
Qualitative findings: The elderly persons described the waiting time as long and stressful. They developed swollen feet and bodily pains due to the long waiting time. They clarified that the diagnostic investigation, medication and consultation fees were expensive, leading to postponement of their subsequent visits and deterioration of their health.
Conclusion: Cost was a determining factor in utilizing healthcare. The study recommends that policy makers should include elderly persons from age 60 years to 69 years in the National Health Insurance exemption policy to enable the majority of them to utilize healthcare. Additionally, there is the need to review visits to the healthcare units to schedule time appointments to reduce the long and stressful waiting time.
. J. A. M. Lubenow, A. J. R. Barrêto, N. J. de Almeida, and S. A. Oliveira, "Access for the Elderly to Primary Health Care Services: an Integrative Review," International Archives of Medicine, vol. 9, no. 1, pp. 1-13, 2016.
. J. Agbogidi and C. Azodo, "Experiences of the Elderly Utilizing Healthcare Services in Edo State " The Internet Journal of Geriatrics and Gerontology, vol. 5 (2), pp. 1-6, 2009.
. G. Agrawal and P. Arokiasamy, "Morbidity prevalence and health care utilization among older adults in India," Journal of Applied Gerontology, vol. 29, no. 2, pp. 155-179, 2010.
. Ghana Statistical Service, "2010 Population & Housing Census Report, the elderly in Ghana," July 2013 2013.
. J. R. Beard et al., "The world report on ageing and health: a policy framework for healthy ageing," Lancet, vol. 387, no. 2145-54, 2016.
. L. K. Chen, "Towards elder-friendly outpatient services," Journal of the Chinese Medical Association, vol. 75, no. 12, pp. 617-8, Dec 2012.
. B. I. I. Saeed, M. Louis, E. N. Aidoo, N. N. Nsowah-Nuamah, A. E. Yawson, and X. Zhao, "Socio-economic inequalities and healthcare utilization in Ghana," International Journal of Business and Social Research, vol. 3, no. 1, pp. 54-63, 2013.
. S. Krishnaswamy et al., "Factors Contributing to Utilization of Health Care Services in Malaysia: A Population-Based Study," Asia-Pacific Journal of Public Health, vol. 21, no. 4, pp. 442-450, 2009.
. Korle-Bu Teaching Hospital, "2016 Annual Report," 2016.
. M. o. H. Ghana Health Service, "Ghana Health Service Annual Report,",2016.
. T. Lehnert et al., "Review: Health Care Utilization and Costs of Elderly Persons with Multiple Chronic Conditions," Medical Care Research and Review, vol. 68, no. 4, pp. 387-420, Aug 2011.
. R. M. Andersen, "Revisiting the Behavioral Model and Access to Medical Care: Does It Matter?," Journal of health and social behavior, vol. 36, pp. 1-10, 1995.
. R. Andersen and J. F. Newman, "Societal and individual determinants of medical care utilization in the United States," The Milbank Quarterly, vol. 83, no. 4, pp. 1-28, 2005.
. D. P. Rebhan, "Health care utilization: understanding and Applying Theories and Models of Health care Seeking Behavior ", W. R. University, Ed., ed, 2008, p. 19.
. C. H. Gong, K. Hal, and H. Xiaojun, "Factors predicting health services use among older people in China: An analysis of the China Health and Retirement longitudinal study," BMC Health Services Research, vol. 16, no. 63, 2016.
. D. Lixia, X. Liu, T. Zhang, and Y. Wu, "Health care utilization in elderly people with cardiovascular disease in China," International Journal for Equity in Health, vol. 14, no. 59, 2015.
. I. Y. Addo and I. A. Gyamfuah, "Determinants of Healthcare facilities and Services Utilisation among the Aged: Evidence from Yamoransa in Ghana," American Scientific Research Journal for Engineering, Technology and Sciences (ASRJETS), vol. 8 (1), no. 42-55, 2014.
. S. Hoeck, G. Frabcois, J. Van der Heyden, and G. Van Hal, "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy vol. 99, no. 174-182, 2011.
. O. N. Chukwudi, I. M. Uyilewhoma, E. J. Ebi, O. O. Kalu, and E. E. Iyamba, "Determinants of Health Services Utilization among the Elderly in Calabar Municipality, Cross River State, Nigeria," European Journal of Preventive Medicine, vol. 3(5), no. 129-136, 2015.
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