Why do older adults choose private healthcare services? Evidence from an urban context in India using Andersen's Behavioral Model

Archives of Gerontology and Geriatrics Plus Pub Date : 2024-12-31 DOI:10.1016/j.aggp.2024.100118

Manik Halder, Nuruzzaman Kasemi

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Abstract

Background

This study investigates the factors influencing older adults’ preference for private healthcare services in an urban Indian setting, guided by Andersen's Behavioral Model. Focusing on Siliguri Municipal Corporation, West Bengal, it examines socio-demographic, economic, and health-related determinants that drive healthcare choices among the elderly.

Methods

Survey was conducted from April to September 2023, gathering primary data from 400 older adults. Binary logistic regression was applied to identify the predisposing, enabling, and need-based factors associated with private healthcare service utilization.

Results

The analysis revealed significant disparities in private healthcare utilization based on age, social group, wealth, working status, health insurance, BMI, and health conditions. Younger elderly adults (young-old) were more likely to opt for private healthcare compared to the oldest-old. Individuals from the General social group showed higher utilization than those from marginalized groups such as SC/ST. Married participants exhibited greater private healthcare utilization, while wealthy individuals were more inclined to access private services. However, insured individuals were less likely to utilize private healthcare, potentially reflecting better access to government services. Employment status also positively influenced private healthcare choices, with working individuals reporting higher utilization. Conversely, health conditions such as ADL limitations, underweight, and obesity were negatively associated with private healthcare use, reflecting unique health and accessibility challenges.

Conclusion

The findings highlight a complex interplay of socio-demographic, economic, and health factors influencing private healthcare choices among older adults in urban India. These insights call for targeted policies to address disparities and enhance equitable healthcare access, particularly for vulnerable groups.

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为什么老年人选择私人医疗服务？使用安徒生行为模型的印度城市背景证据

本研究在安徒生行为模型的指导下，调查了影响印度城市老年人对私人医疗服务偏好的因素。它以西孟加拉邦西里古里市政公司为重点，审查了推动老年人选择医疗保健的社会人口、经济和健康相关决定因素。方法于2023年4月至9月进行调查，收集400名老年人的原始数据。应用二元逻辑回归来确定与私人医疗保健服务利用相关的易感性、启用性和基于需求的因素。结果分析发现，年龄、社会群体、财富、工作状态、健康保险、身体质量指数、健康状况等因素对民营医疗服务的利用存在显著差异。与老年人相比，年轻的老年人（young-old）更有可能选择私人医疗保健。来自一般社会群体的个体比来自SC/ST等边缘群体的个体表现出更高的利用率。已婚参与者表现出更多的私人医疗保健利用，而富人更倾向于获得私人服务。然而，有保险的个人利用私人医疗保健的可能性较低，这可能反映了获得政府服务的机会较好。就业状况也对私人医疗保健选择产生积极影响，有工作的个人报告的使用率更高。相反，ADL限制、体重不足和肥胖等健康状况与私人医疗保健使用呈负相关，反映了独特的健康和可及性挑战。结论：研究结果强调了影响印度城市老年人私人医疗选择的社会人口、经济和健康因素的复杂相互作用。这些见解要求制定有针对性的政策，以解决差距问题，并加强公平获得医疗保健的机会，特别是针对弱势群体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Archives of Gerontology and Geriatrics Plus

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