Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians

Saeed, Bashiru I. I.; Zhao, Xicang; Yawson, Alfred Edwin; Nguah, Samuel Blay; Nsowah-Nuamah, N. N. N.

doi:10.1186/s12889-015-1603-y

Cited by 34 publications

(43 citation statements)

References 9 publications

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“…Additionally, Kotoh et al (2018) [ 15 ] in their study on factors that influence enrolment and retention in the NHIS in the Central and Eastern regions of Ghana, found that females constituted more than half of those who were covered. One of the likely reasons for this gender difference is that women tend to report poorer health status compared to men [ 29 , 30 ]. Women are thus more likely to need healthcare, explaining why they were more likely to be covered.…”

Section: Discussionmentioning

confidence: 99%

Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme

Dake

2018

Int J Equity Health

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BackgroundFollowing years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This paper examines equity in coverage under Ghana’s National Health Insurance Scheme (NHIS).MethodsSecondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females (15–49 years) and 4568 males (15–59 years) were analysed using descriptive, bivariate and multivariate methods. Concentration curves and indices were used to examine equity in coverage on the NHIS.ResultsAs at 2008, more than 60% of Ghanaians aged 15–59 years were not covered under the NHIS with slightly more females (38.9%) than males (29.7%) covered. Coverage was highest among the highly educated, professionals, those from households in the richest wealth quintile and urban residents. Lack of coverage was most concentrated among the poor.ConclusionsUniversal coverage under the NHIS is far from being achieved with marked exclusion of the poor. There is the need for deliberate action to enrol the poor under the NHIS.

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Section: Discussionmentioning

confidence: 99%

Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme

Dake

2018

Int J Equity Health

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“…With the rising prevalence of chronic diseases, the health system in Ghana is less prepared to meet the health care needs of the elderly, with little infrastructure and few specialized personnel for older populations [ 30 ]. Further, in terms of health access, Saeed et al found that most elderly persons in Ghana reporting poor health use health facilities more owing to the National Health Insurance policy which offers free healthcare to elderly persons above 70 years [ 31 ]. While this is seen as a positive development at national level, the quality of services rendered are not encouraging and the range of services offered are limited.…”

Section: Introductionmentioning

confidence: 99%

Predictors of self-reported health among the elderly in Ghana: a cross sectional study

et al. 2017

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BackgroundSelf-reported health is a widely used measure of health status across individuals. As the ageing population increases, the health of the elderly also becomes of growing concern. The elderly go through life facing social, economic and financial hardships. These hardships are known to affect the health status of people as they age. The purpose of this study is to assess social and health related factors of self-reported health among the elderly in Ghana.MethodsA multivariate regression analysis in form of a binary and ordinal logistic regression were used to determine the association between socioeconomic, demographic and health related factors, on self-reported health. The data used for this study was drawn from the World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) Wave 1.ResultsIn total, out of 2613 respondent, 579 (20.1%) rated their health status as poor and 2034 (79.9%) as good. The results showed that the odds of reporting poor health was 2.5 times higher among the old-old compared to the young old. The elderly with one or more than one chronic condition had the odds of 1.6 times and 2 times respectively, of reporting poor health. Engaging in mild to moderate exercise increased the chances of reporting poor health by 1.8 times. The elderly who had never worked in a lifetime were 2 times more likely to report poor health. In the same way, residents of Eastern and Western parts of Ghana were 2 times more likely to report poor health compared to those in the Upper West region. Respondents with functional limitations and disabilities were 3.6 times and 2.4 times respectively, more likely to report poor health. On the other hand, the odds of reporting poor health was 29, 36 and 27% less among respondents in the highest income quintiles, former users of tobacco and those satisfied with certain aspects of life respectively. Also, current alcohol users were 41% less likely to report poor health.ConclusionThe health status of the elderly is to an extent determined by the circumstances in which they are born, grow and live. The findings suggest that addressing social issues faced by individuals in youthful age will go a long way to achieving good health in the future. People with physical limitations and disabilities are most vulnerable to unmet healthcare needs and support system from government, policy makers and family.

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“…To obtain a responsiveness index, the scores for each domain were first reverse coded to 5 = very good and 1 = very bad and then added, resulting in an index ranging from 6, indicating the lowest, to 30, the highest score. 2 Chi-square tests were applied to compare the health systems' responsiveness domains according to the possession or not of health insurance. Since a nonnormal distribution of the index was observed, a median quantile regression (50 th percentile) was used to explore the specific association of the responsiveness index with health insurance ownership and socio-demographic factors.…”

Section: Discussionmentioning

confidence: 99%

“…In low and middle-income countries (LMIC), health care systems are likely to be challenged by the rapidly increasing numbers of the elderly population. 1,2 A large proportion of this group will be socioeconomically disadvantaged and will live in rural areas with poor health care infrastructure. 3,4 Compounding this situation is the increasing need for health care services adapted to noncommunicable diseases like diabetes, hypertension, a variety of cancers and deteriorating physical mobility, which predominantly affect the elderly.…”

Section: Introductionmentioning

confidence: 99%

Responsiveness of The Health Care System Towards The Elderly In Tanzania: Does Health Insurance Make a Difference? A cross Sectional Study

Amani

Tungu

Hurtig

et al. 2020

Preprint

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Background Responsiveness has become an important tool in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of health insurance among the elderly in the country. Methods This is across sectional study. We used a pre-tested household survey administered to elderly (60 years +) living in Igunga and Nzega districts. Participants with and without health insurance attending outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to explore the specific association of the responsiveness index with health insurance and socio-demographic factors. Results A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.

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Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians

Cited by 34 publications

References 9 publications

Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme

Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme

Predictors of self-reported health among the elderly in Ghana: a cross sectional study

Responsiveness of The Health Care System Towards The Elderly In Tanzania: Does Health Insurance Make a Difference? A cross Sectional Study

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