Examining the predictors of healthcare facility choice for outpatient care among older adults in India using Andersen’s revised healthcare utilization framework model
Authors
Margubur Rahaman
Senior Research Fellow, Department of Migration & Urban Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088 India
Pradip Chouhan
Professor, Department of Geography, University of Gour Banga, Malda, 732103 India
Avijit Roy
State Aided College Teacher, Department of Geography, Malda College, Malda, 732101 India
Md Rana
Assistant Professor, Govind Ballabh Pant Social Science Institute (GBPSSI), Allahabad, 211019 India
Kailash Das
Professor, Department of Migration & Urban Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088 India
Keywords:
Outpatient care, Older adults, Healthcare responsiveness, Spatial patterns, India
Abstract
In India, the demand for outpatient care is substantially higher than inpatient care among older adults. Therefore, the current study examines the level, patterns, and factors associated with outpatient care use.
Methods
The present research used data from the first wave of the Longitudinal Ageing Study in India (LASI, 2017–18). A total of 34,588 older adults (45 years and above) who accessed outpatient healthcare services in one year prior to the survey were included in this study. A bivariate chi-square test was applied to present the percentage distribution of types of outpatient healthcare utilization by background characteristics and healthcare responsiveness. Multinomial logistic regression analyses were employed to explore the interplay of outpatient healthcare utilization and allied predisposing, enabling, and need factors.
Results
About 63.7% of total older adults used a private facility, followed by 22.8% used a public facility, and 13.5% used other facilities. Years of schooling, household wealth status, place of residence, self-rated health, and health insurance were all found to be significant determinants of public or private facility use. In contrast, respondents' sex was found to be a significant determinant of private healthcare use only. The study finds that there was inadequate healthcare reaction to public health facilities.
Conclusion
The current study revealed that the use of private facility for outpatient care is noticeably high in India. Older adults' educational attainments, health insurance coverage, and household level economic background were found to be significant factors in healthcare choice. The current study emphasizes the need to strengthen public healthcare services for outpatient care.
Keywords: Outpatient care, Older adults, Healthcare responsiveness, Spatial patterns, India
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