Determinants of accessing healthcare services for outpatient care: A study on older adults in India

ABSTRACT

This study aims to investigate the determinants of outpatient healthcare selection. The present research utilised data from the first wave of the Longitudinal Ageing Study in India, 2017–18). A total of 34,588 older individuals (45 years and above) who accessed outpatient healthcare services in the last 12 months during the survey were included in this study. A bivariate chi-square test was used to present the percentage distribution of types of outpatient healthcare utilisation by background characteristics and healthcare responsiveness. Multinomial logistic regression analyses were used to investigate the relationship between outpatient healthcare utilisation and other predisposing, enabling, and need factors. About 57.3% of older adults used a private service, 30.2% used a public service, and 12.4% used other services. Years of schooling, wealth, place of residence, self-rated health, and health insurance were all important factors in determining whether older adults sought outpatient treatment from a public or private service. Public health facilities reveived inadequate healthcare response. The current study suggested that education, wealth, place of residence, and health insurance were significant determinants of private and public outpatient healthcare utilisation. Therefore, the current study emphasises the need to strengthen public healthcare services to ensure universal access to health care.

KEYWORDS:

• Outpatient care
• Older adults
• Healthcare responsiveness
• LASI wave-1
• India

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Authors’ contributions: MR and PD conceptualised the study aims and designed the study. AR, and JS assisted with the interpretation of the analysis/results and manuscript writing. PC assisted with different parts of the manuscript editing/writing and prepared the final draft of the manuscript. All authors read and approved the final manuscript.

Ethics approval and consent to participate: Not applicable; this is a secondary-based survey. No patient could be identified or contacted for this study, and individual researchers required no ethics approval to undertake this study. The LASI Data were collected under the approved ethical consideration of the Indian Council of Medical Research (ICMR) guidelines. (Please refer to the document National ethical guidelines for biomedical and health research involving human participants link to the document- https://main.icmr.nic.in/sites/default/files/guidelines/ICMR_Ethical_Guidelines_2017.pdf).

Consent for publication: Not applicable.

Availability of data and materials: The datasets are publicly available in iipsindia.ac.in the website.

Additional information

Notes on contributors

Margubur Rahaman

Margubur Rahaman MR is a doctoral researcher at the Department of Migration & Urban Studies at the International Institute for Population Sciences, Mumbai, India. He is currently working on reproductive health matters of homeless women in the Kolkata megacity, India. The author has published several research articles in highly recognized journals, including BMC Public Health, BMC Geriatrics, Journal of Biosocial Science, Indian Journal of Labour Economics, Clinical Epidemiology and Global Health, and BMC Women's Health.

Puja Das

Puja Das PD is a Ph.D. scholar in geography at the University of Gour Banga, India. Her current research interests include public health issues. The author has published research articles in highly recognized journals, including BMC Public Health and Heliyon.

Pradip Chouhan

Pradip Chouhan PC is a Professor of Geography at the Department of Geography, University of Gour Banga, India. The author has published several research articles and books in nationally and internationally recognized journals. The author has published several research articles in highly recognized journals, including BMC Public Health, BMC Women's Health, Journal of Health Management, Children, Nutrients, Geo Journal, Indian Journal of Labour Economics, Spatial and Spatio-temporal Epidemiology, International Journal of Infectious Diseases, PLoS ONE, and OMEGA-Journal of Death and Dying.

Avijit Roy

Avijit Roy AR is presently working as a State Aided College Teacher (SACT) at the Department of Geography, Malda College, West Bengal, India. His current research interests include child marriage and public health issues. The author has published several research articles in highly recognized journals, including BMC Public Health, BMC Women's Health, The European Journal of Contraception & Reproductive Health Care, Vulnerable Children and Youth Studies, Clinical Epidemiology, and Global Health.

Jay Saha

Jay Saha JS currently works at the Department of Geography, the University of Gour Banga, Malda, India, as a Ph.D. scholar. His research interest include child nutrition, morbidity, human mobility, fertility, and other public health issues. The author has published several research articles in highly recognized journals, including Children and Youth Services Review, Clinical Epidemiology and Global Health, The European Journal of Contraception and Reproductive Health Care, Environmental Pollution, PLoS ONE, Spatial and Spatio-temporal Epidemiology, International Journal of Infectious Diseases, Children, Nutrients, and Parasite Epidemiology and Control.