Differentials and predictors of hospitalisation among the elderly people in India: evidence from 75th round of National Sample Survey (2017-2018)

Abstract

Purpose There is limited evidence on the determinants of hospitalisation and its causes in India. This study aims to examine the differential in the hospitalisation rates and its socioeconomic determinants. This study also examines the causes of diseases in hospitalisation among the elderly (≥60 years) in India. Design/methodology/approach This study used data from the 75th round of the National Sample Survey Organizations, collected from July 2017 to June 2018. The elderly samples in this survey are 42,759, where 11,070 were hospitalised, and 31,689 were not hospitalised in the past year or 365 days. This study estimated hospitalisation rates and carried out binary logistic regression analysis to examine the associations of hospitalisation with the background variables. The cause of diseases in hospitalisations was also calculated. Findings The hospitalisation rate was lower among elderly female compared to elderly male. Elderly who belongs to middle-old aged groups, non-married, North-Eastern region, Southern region, general caste, health insurance, partially and fully economically dependent have a higher chance of being hospitalised. About 38% elderly were hospitalised due to communicable diseases (CDs), 52% due to non-communicable diseases (NCDs) and 10% due to injuries and others (IO). Nearly 40% elderly were hospitalised in public hospitals due to CDs, whereas 52% were hospitalised in private hospitals due to NCDs and 11% due to IO. Research limitations/implications Firstly, this study is based on cross-sectional survey due to which temporal ambiguity averted to draw causal inferences. Secondly, other significant factors can also predict hospitalisations and provide insightful results, such as lifestyle factors, behavioral factors, obesity, mental state and several personal habits such as smoking cigarettes, drinking alcohol, consuming tobacco or other harmful substances. But this information was not available in this study. Even with these limitations, the hospitalisation issues among the elderly are beneficial to understand the current circumstances of CDs, NCDs and injury and other diseases for India and its states to formulate health policy. Practical implications Early screening and early treatment for NCDs are needed, which are non-existent in almost all parts of India. It is essential to necessitate and identify the important factors that best predict hospitalisation or re-visit of hospital admission. Although, the medical advances in India have made rapid strides in the past few decades, it is burdened none the less, as the doctor–patient ratio is very low. It is important to develop preventive measures to minimize the accidents and causalities to avoid substantial cost associated with elderly health care. Social implications Raising awareness, promotion of healthy life style and improving the quality of good health-care provisions at primary level is a necessity. Originality/value The findings, practical and social implications provide a way forward for the health policymakers to potentially alter the future research to reduce associated comorbidities, unnecessary hospitalisations and other medical complications.

Trends, changes and determinants of medical attention received before death among deceased adults in India: Evidence from pooled cross-sectional survey data (2004-2018)

“…In contrast, the recent SRS report (2019) found that, with the exception of Kerala, all other southern states (Tamil Nadu, Telangana, Karnataka, and Andhra Pradesh) had below the national average percentage of medical attention before death (SRS Report, 2019). On the other hand, our finding has also revealed that Eastern region is significantly more likely to receive medical attention before death which is also an exceptional result while previous studies showed a contradictory results (Akhtar & Saikia, 2022; Pandey et al, 2017a, 2017b). Even, the SRS report (2019) has documented that except Odisha, all other easter states (West Bengal, Bihar and Jharkhand) had lower percentage of receiving medical attention before death for all ages than the national average (SRS Report, 2019).…”

“…Surprisingly, our result has revealed that Southern and Western regions are found to have significantly less likely to receive medical attention before death among deceased adults which is a striking finding. While the previous studies have found that older adults belong to Southern region were more likely receive hospitalizations (Akhtar & Saikia, 2022; Banerjee, 2021; Giridhar et al, 2014; Pandey et al, 2017a, 2017b). In contrast, the recent SRS report (2019) found that, with the exception of Kerala, all other southern states (Tamil Nadu, Telangana, Karnataka, and Andhra Pradesh) had below the national average percentage of medical attention before death (SRS Report, 2019).…”

“…Interestingly, our finding revealed that females are showing negative change in receiving medical attention than male and the odds of receiving medical attention is higher among female than males but did not show significant while similar results have been also reflected in other studies (Ghosh & Sengupta, 2016; Gupta & Sankar, 2004). Though, female lifespan has much improved in India compared but still the heterogeneity exists in seeking health care as they are more economically dependent on others and financially vulnerable too (Akhtar & Saikia, 2022; Maharana & Ladusingh, 2014; Moradhvaj & Saikia, 2019; Saikia, Moradhvaj, et al, 2016). Furthermore, there are not many community-based health centers that is dedicated solely to women’s needs.…”

“…While other studies may appear counterintuitive that people ignore seeking medical attention that could save their lives or alleviate their health problems (Kannan & Veazie, 2014; Leyva et al, 2020; Spleen et al, 2014). Recent studies in India have showed that older adults have a lower health-related quality of life (Akhtar & Saikia, 2022; Boro et al, 2021; Kumar & Kumar, 2022; Kundu et al, 2022), and have a higher prevalence of multiple chronic illness (Chauhan et al, 2022; Khan et al, 2021). Because of their greater medical needs, older persons may be more exposed to the negative health implications of postponing medical care.…”

Regional mortality variations among older adults in India: Evidence from Demographic Health Survey

“…Though Central region has a shorter life expectancy and a smaller proportion of older individuals than the Northern region (SRS Report, 2019). In the Central region, poor health-care facilities and negligence of visiting health care centres are also linked to a higher death risk among older adults (Akhtar & Saikia, 2022; Banerjee, 2021). As a result, it is recommended that each state in the central region emphasize the importance of disease prevention and control, raise disease prevention awareness, and develop strategic scientific measures to reduce mortality risks and control critical areas and populations while taking into account the current situation in the region.…”