Healthcare access and utilisation trends among the elderly in India: Evidence from the LASI Wave-1 survey

Abstract

Background

Population ageing is a global trend, driven by increased life expectancy, which has led to a rise in chronic diseases and greater healthcare needs among older persons. Despite the implementation of national policies and initiatives such as the National Programme for Health Care of the Elderly (NPHCE), Ayushman Bharat and the National Health Policy 2017, older persons, particularly in rural areas, still face barriers to accessing healthcare, including cost, distance, and the quality of care. Socio-economic factors continue to play a key role in healthcare utilisation. This study examines the healthcare access and utilisation patterns and identifies associated determinants among older persons using nationally representative data.

Methods

This study analysed cross-sectional data from the Longitudinal Ageing Study in India (LASI) Wave I Survey (2017–18), which included 31,902 individuals aged 60 years and above. Data from the Individual Schedule was analysed, focusing on healthcare utilisation and related factors. Binary logistic regression was conducted to assess factors influencing outpatient (OPD) and inpatient (IPD) service use. Adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were reported, and a p value of <0.05 was considered statistically significant.

Findings

Lack of health insurance reduced OPD use (aOR: 0.869, p = 0.006). Females were less likely to use IPD services (aOR: 0.818, p < 0.001), while individuals aged >90 years had higher odds (aOR: 1.470, p < 0.001). Religion, socioeconomic status, and literacy significantly influenced utilisation. Christians and Buddhists had higher IPD use; Muslims and Sikhs had lower odds. Richer groups were less likely to use both services. Limited literacy was linked to reduced OPD use. The North-East reported the highest OPD expenses and travel distances.

Interpretations

There is a pressing need to address healthcare access gaps among older persons through targeted policies and improved outreach. Expanding affordable health insurance can reduce out-of-pocket costs and improve health outcomes in India's ageing population, addressing key Sustainable Development Goals (SDGs), particularly SDG 1,3,10 and 11.