Utilization of Healthcare Services by the Elderly Patients at Korle-Bu Teaching Hospital, Accra
AbstractObjective: 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.
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