Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China

Reasons for underutilization of community care facilities for the elderly in China

BACKGROUND

China's government has invested a great deal of resources to improve the coverage rate of community care facilities for the elderly. However, the facilities that have been built are underutilized.

METHODS

Referring to the Anderson model, a framework for analyzing the utilization of community care facilities for the elderly was constructed. Descriptive statistics on survey data from 17 communities demonstrated the status of the utilization, and binary logistic regression analysis examined the influencing factors of the utilization.

RESULTS

Built community care facilities for the elderly are underutilized and there are significant differences in the influencing factors of the utilization between daily care facilities, medical care facilities, recreation facilities, and spiritual comfort facilities.

CONCLUSIONS

The main reasons for the underutilization can be delineated as follows: (1) The demand for community care facilities is outstripped by the supply, resulting in a surplus; (2) Complex constraints on demand for facilities due to insufficient enabling resources; (3) Inadequacy of community care facilities in meeting expectations. (4) High substitutability of community care facilities; (5) Bureaucratic pressure hindering facility development. To address the underutilization of community care facilities, it is recommended to clarify the community responsibility boundaries for elderly care and the role that the market plays in community care facilities for the elderly.

Exploring Drivers of Healthcare Utilization among the Working and Non-Working Elderly Population: Insights from LASI

BACKGROUND

The elderly population of India has been growing exponentially over the past few decades, caused by a decline in fertility and an increase in life expectancy. The growth eventually has transcended the disease burden on the public healthcare system. This calls for a need to evaluate the healthcare utilization pattern of the elderly based on their socioeconomic and working condition.

METHODS

Study used access to public and private healthcare services to measure healthcare utilization. Descriptive analysis and multivariable logistic regression were used to understand utilization patterns by working status and some selected sociodemographic parameters. All the results were reported at a 95% confidence interval.

RESULTS

Using the data from the first wave of Longitudinal Ageing Study in India (LASI) with a sample of 22,680 older persons 60 years and above. The study identified that 50% of the working elderly access private services; however, 26% access public healthcare services. It was found that the working status of the elderly alone did not influence access to healthcare services, but education is also an essential indicator for utilizing healthcare services. Further, factors such as gender, marital status, religion, wealth, tobacco usage, self-rated health, ADL and IADL were significant predictors of healthcare services' utilization for the elderly.

CONCLUSION

This study suggests that there are not many differences found among working and non-working status with healthcare utilization, although some sociodemographic indicators are associated with the utilization of healthcare services, highlighting that increasing health needs among the elderly requires strengthening the quality and appropriate public investment in health.

Media Use Behavior Mediates the Association Between Family Health and Intention to Use Mobile Health Devices Among Older Adults: Cross-Sectional Study

BACKGROUND

With the advent of a new era for health and medical treatment, characterized by the integration of mobile technology, a significant digital divide has surfaced, particularly in the engagement of older individuals with mobile health (mHealth). The health of a family is intricately connected to the well-being of its members, and the use of media plays a crucial role in facilitating mHealth care. Therefore, it is important to examine the mediating role of media use behavior in the connection between the family health of older individuals and their inclination to use mHealth devices.

OBJECTIVE

This study aims to investigate the impact of family health and media use behavior on the intention of older individuals to use mHealth devices in China. The study aims to delve into the intricate dynamics to determine whether media use behavior serves as a mediator in the relationship between family health and the intention to use mHealth devices among older adults. The ultimate goal is to offer well-founded and practical recommendations to assist older individuals in overcoming the digital divide.

METHODS

The study used data from 3712 individuals aged 60 and above, sourced from the 2022 Psychology and Behavior Investigation of Chinese Residents study. Linear regression models were used to assess the relationships between family health, media use behavior, and the intention to use mHealth devices. To investigate the mediating role of media use behavior, we used the Sobel-Goodman Mediation Test. This analysis focused on the connection between 4 dimensions of family health and the intention to use mHealth devices.

RESULTS

A positive correlation was observed among family health, media use behavior, and the intention to use mHealth devices (r=0.077-0.178, P<.001). Notably, media use behavior was identified as a partial mediator in the relationship between the overall score of family health and the intention to use mHealth devices, as indicated by the Sobel test (z=5.451, P<.001). Subgroup analysis further indicated that a complete mediating effect was observed specifically between family health resources and the intention to use mHealth devices in older individuals with varying education levels.

CONCLUSIONS

The study revealed the significance of family health and media use behavior in motivating older adults to adopt mHealth devices. Media use behavior was identified as a mediator in the connection between family health and the intention to use mHealth devices, with more intricate dynamics observed among older adults with lower education levels. Going forward, the critical role of home health resources must be maximized, such as initiatives to develop digital education tailored for older adults and the creation of media products specifically designed for them. These measures aim to alleviate technological challenges associated with using media devices among older adults, ultimately bolstering their inclination to adopt mHealth devices.