The Utilization of Outpatient Health Services and the Associated Factors Among the Older Adults Covered by Comprehensive Health Service Centers in Rasht

Mohadeseh Nejadghasem, Shahla Asiri, Abdolhosein Emami Sigaroudi, Ehsan Kazemnezhad
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Abstract

Background: The increase in the older adult population has resulted in a higher demand for outpatient health services and subsequently increased costs paid by older adults. Objectives: This study conducted in Rasht aimed to determine the utilization of outpatient health services among older adults covered by comprehensive health service centers and the factors associated with it. Methods: This cross-sectional analytical study was conducted on 384 older adults aged 60 years and older covered by comprehensive health service centers. The sampling method was stratified random sampling based on consecutive sampling. The information required was collected through a researcher-made two-part questionnaire, including individual-social characteristics and outpatient services, via interviews. Data were analyzed using SPSS version 21 software. The significance level of the tests was considered to be P < 0.05. Results: The results showed that 82.8% of the older adults required outpatient services and 90.9% of them actually received these services. Out of the total, 65.1% went to private sector facilities, 17% to public facilities, and the remaining 18% visited facilities in both sectors. The main reasons for not utilizing outpatient services were the lack of money and the inability to pay. Factors such as place of residence (P = 0.014, OR = 2.417), the presence of chronic disorders (P = 0.047, OR = 1.689), health status (P = 0.012, OR = 0.619), and education level (P = 0.05, OR = 0.763) were found to be associated with the utilization of outpatient services. Conclusions: Two-thirds of the sample had chronic diseases, most of them received outpatient services from the private sector, and about 75% of those who did not receive the service could not afford the costs. Therefore, it is necessary to improve the quality of outpatient services in the public sector and enhance their accessibility. Some individuals were unaware of health screenings for older adults in the comprehensive health services centers, so informing them about these services can be useful in promoting their utilization by older adults and reducing the costs of outpatient services.
拉什特综合保健服务中心覆盖的老年人对门诊保健服务的利用情况及其相关因素
背景:老年人口的增加导致对门诊医疗服务的需求增加,老年人支付的费用也随之增加。研究目的在拉什特进行的这项研究旨在确定综合医疗服务中心所覆盖的老年人对门诊医疗服务的利用情况及其相关因素。研究方法这项横断面分析研究的对象是综合医疗服务中心覆盖的 384 名 60 岁及以上老年人。抽样方法是基于连续抽样的分层随机抽样。所需信息通过研究人员自制的两部分问卷收集,包括个人社会特征和门诊服务。数据使用 SPSS 21 版软件进行分析。检验的显著性水平为 P <0.05。结果显示结果显示,82.8% 的老年人需要门诊服务,其中 90.9% 的老年人实际接受了这些服务。其中,65.1%的人去了私立医疗机构,17%的人去了公立医疗机构,其余 18%的人去了两家医疗机构。不使用门诊服务的主要原因是缺钱和无力支付。研究发现,居住地(P = 0.014,OR = 2.417)、是否患有慢性疾病(P = 0.047,OR = 1.689)、健康状况(P = 0.012,OR = 0.619)和教育水平(P = 0.05,OR = 0.763)等因素与门诊服务的使用情况有关。结论三分之二的样本患有慢性病,其中大部分人接受了私营部门提供的门诊服务,而未接受服务的人中约有 75% 无力承担费用。因此,有必要改善公共部门的门诊服务质量,提高其可及性。有些人不知道综合保健服务中心为老年人提供健康检查,因此向他们介绍这些服务有助于促进老年人利用这些服务,降低门诊服务费用。
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