Health Care Utilization by Older Adults in Nepal: An Investigation of Correlates and Equity in Utilization

Ghimire, Saruna; Singh, Devendra Raj; McLaughlin, Sara J.; Maharjan, Renusha; Nath, Dhirendra

doi:10.1177/0020731420981928

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…More monthly household income makes people more likely to use health services. Acharya et al [ 14 ], Gurung et al [ 4 ], Spaan et al [ 32 ], Babitsch et al [ 33 ], and Ghimire et al [ 34 ] also revealed an association among health service utilization, household income, and distance to the health facilities. It indicates that financial hardship is the greatest barrier to utilizing the health services among senior citizens.…”

Section: Discussionmentioning

confidence: 99%

Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study

Chhetri,

Khatri,

Gahatraj

2023

Journal of Aging Research

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Background. Senior citizens are usually infected by multiple chronic conditions and other health problems. Health needs and demand for healthcare services increase with age. However, healthcare services and facilities and their utilization are limited, particularly in developing countries. Aims. To identify the utilization of health services among senior citizens and their contributing factors. Methods. A cross-sectional analytic study was conducted among 293 senior citizens of the Kushma municipality, Nepal, from June to December 2019. A structured questionnaire was used as a data collection tool using a multistage sampling technique. Face-to-face interviews were conducted to collect data on the interview schedule. Reliability and validity were maintained by applying different strategies and carefully developing tools, pretesting, double entry, and validation. Data entry, management, and analysis were performed using Epi Data and SPSS software. Research ethics were maintained. Descriptive and inferential statistical tests were performed to infer the findings. Results. Study participants had a mean age (±SD) of 70.08 (±7.6) years and had various preexisting chronic diseases such as hypertension (46%), gastritis (41.9%), arthritis (34.3%), and asthma (28.7%). Only eight out of ten senior citizens had used health services in the past year. Factors such as age, ethnicity, residency, household income, family support, the presence of chronic diseases, and being under medication were found to have statistically significant associations with the utilization of health services among senior citizens with a p value less than 0.05 and 95% confidence interval. Conclusions. A remarkable proportion of older people reported using health services in the last year. However, a substantial proportion did not utilize health services that require further interventions to enable them. Efforts are required to promote the health and well-being of Nepal’s growing elderly population, including potential enhancements to rural healthcare infrastructure by policymakers.

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Section: Discussionmentioning

confidence: 99%

Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study

Chhetri,

Khatri,

Gahatraj

2023

Journal of Aging Research

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“…The recognition of quality health care's significance Advances in Public Health for older individuals is growing on a policy level, with governments worldwide initiating efforts to enhance the healthrelated quality of life for their older populations [77]. These initiatives include policies that subsidize health care for older persons, stimulating the demand for targeted and effective medical services tailored to their needs [78]. Increased government funding for research on age-related health issues has led to breakthroughs in understanding and treating ailments prevalent among older people [79].…”

Section: Social and Societalmentioning

confidence: 99%

Challenges and Advancements in the Health-Related Quality of Life of Older People

Rony,

Parvin,

Wahiduzzaman

et al. 2024

Advances in Public Health

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Background. With the global trend of increasing life expectancy, the health-related quality of life of older people haspersonalised become an area of significant interest. It is crucial to comprehend the advancements and identify the ongoing challenges in this domain for better health management and policy formation. Objectives. This scoping review aimed to comprehensively investigate the existing challenges and recent advancements associated with the quality of health among older people. Methods. We utilized Arksey and O’Malley’s scoping review framework for this study. A systematic literature search was performed across multiple databases, namely, PubMed, Scopus, and Google Scholar, targeting publications from 2018 to 2023. Selected studies were then rigorously examined based on predefined inclusion and exclusion criteria, followed by an in-depth thematic analysis. Results. Of the initial 406 identified studies, 72 were included in the final review. The analysis underscored enduring challenges in physical and medical issues, psychological difficulties, socioeconomic obstacles, and policy-related challenges. Meanwhile, significant advancements were noted in several areas, including technology, medicine, social and societal facets, and policy. Conclusions. Despite noteworthy improvements in the health-related quality of life of older individuals, the continued presence of substantial challenges emphasizes the need for more targeted initiatives. These results suggest an immediate requirement for revising policies and implementing interventions that specifically address identified challenges, with a particular emphasis on ensuring equitable health care access, effectively managing chronic conditions, and enhancing the training of geriatric health care professionals. This comprehensive review serves as a roadmap for guiding future research and shaping policy directions in the health care of older people.

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Older people’s challenges accessing health services in central Nepal: a qualitative study using the domain of access framework

Adhikari,

Shah,

Khanal

2024

BMC Health Serv Res

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Background Low- and middle-income countries face rapid population aging. However, the health system has remained largely unprepared to deliver health services to an aging population. As the population is rapidly aging in Nepal, their challenges and experience should be the focus for health care providers to address these issues. There is a paucity of evidence on barriers and facilitators to accessing health care services among older people in Nepal. The aim of this study was to investigate the challenges that older people experience while accessing health services in central Nepal. Methods This qualitative study was conducted between April and June 2023. In-depth interviews were conducted among older people of a municipality in central Nepal, which were analysed thematically using a deductive-inductive approach based on the theory of access. Results Hypertension and diabetes were the most common health problems among the participants. The affordability of health services was a major issue, although there is a health insurance scheme and a major focus on universal health coverage from the Government of Nepal. Other issues included poor acceptability, poor communication between older people and health staff, and poor accommodation due to a lack of elderly-friendly services, including long wait times in the clinic. Living with family was a major facilitator of access to health care services and was interrelated with multiple domains of access. Conclusions This study identified barriers to accessing health care services for older adults in Nepal. We found that the affordability of health services, poor acceptability, poor communication between older people and doctors, and a lack of elderly-friendly services are the key challenges experienced by older people. Older people felt that these barriers were easier to overcome when they had family support. Therefore, for those living with their children, family support was reported as the major facilitator. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-024-11717-2.

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Health Care Utilization by Older Adults in Nepal: An Investigation of Correlates and Equity in Utilization

Cited by 6 publications

References 27 publications

Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study

Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study

Challenges and Advancements in the Health-Related Quality of Life of Older People

Older people’s challenges accessing health services in central Nepal: a qualitative study using the domain of access framework

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