Morbidity Pattern and Health-seeking Behavior of Aged Population residing in Shimla Hills of North India: A Cross-Sectional Study

Health Service Utilization and Its Determinants among Senior Citizens in the Semiurban Area of Western Nepal: A Cross-Sectional Study

Background

Senior citizens are usually infected by multiple chronic conditions and other health problems. Health needs and demand for healthcare services increase with age. However, healthcare services and facilities and their utilization are limited, particularly in developing countries.

Aims

To identify the utilization of health services among senior citizens and their contributing factors.

Methods

A cross-sectional analytic study was conducted among 293 senior citizens of the Kushma municipality, Nepal, from June to December 2019. A structured questionnaire was used as a data collection tool using a multistage sampling technique. Face-to-face interviews were conducted to collect data on the interview schedule. Reliability and validity were maintained by applying different strategies and carefully developing tools, pretesting, double entry, and validation. Data entry, management, and analysis were performed using Epi Data and SPSS software. Research ethics were maintained. Descriptive and inferential statistical tests were performed to infer the findings.

Results

Study participants had a mean age (±SD) of 70.08 (±7.6) years and had various preexisting chronic diseases such as hypertension (46%), gastritis (41.9%), arthritis (34.3%), and asthma (28.7%). Only eight out of ten senior citizens had used health services in the past year. Factors such as age, ethnicity, residency, household income, family support, the presence of chronic diseases, and being under medication were found to have statistically significant associations with the utilization of health services among senior citizens with a p value less than 0.05 and 95% confidence interval.

Conclusions

A remarkable proportion of older people reported using health services in the last year. However, a substantial proportion did not utilize health services that require further interventions to enable them. Efforts are required to promote the health and well-being of Nepal's growing elderly population, including potential enhancements to rural healthcare infrastructure by policymakers.

Predictors of Out-of-Pocket Expenditure on Health Incurred by Elderly Persons Residing in a Rural Area of Faridabad District

BACKGROUND

A significant portion of India's 1.2 billion population consists of elderly individuals, accounting for approximately 8.6%, who incur substantial out-of-pocket (OOP) healthcare expenses. Any policy for the elderly should encompass financial protection from illness-related expenditures. However, the lack of comprehensive information on OOP expenditure and its determinants precludes such action.

METHODS

We conducted a cross-sectional study of 400 elderly persons residing in the rural town of Ballabgarh. The participants were randomly selected using the health demographic surveillance system. We utilized questionnaires and tools to assess the costs associated with outpatient and inpatient services in the previous year, as well as gather information on socio-demographics (individual characteristics), morbidity (motivation for seeking care), and social engagement (health-seeking).

RESULTS

A total of 396 elderly persons participated, with a mean (SD) age of 69.4 (6.7), and 59.4% females. Nearly 96% and 50% of the elderly availed of outpatient and inpatient services, respectively, in the preceding year. The mean (IQR) annual OOP expenditure, as per the consumer price index 2021, was INR 12,543 (IQR, INR 8,288-16,787), with a median of INR 2,860 (IQR, INR 1,458-7,233), explained significantly by sex, morbidity status, social engagement, and mental health.

CONCLUSION

In low-middle-income countries like India, policymakers may consider pre-payment mechanisms like health insurance for the elderly, using such prediction scores.

Healthcare-seeking experiences of older citizens in Bangladesh: A qualitative study

Despite improvements in many health indicators in the last few decades, providing access to affordable and quality healthcare for older citizen remains a considerable challenge in Bangladesh. This study aimed to understand individuals 'experiences regarding their healthcare-seeking, treatment cost, accessibility and coping mechanisms for the promotion of appropriate strategies to enhance the quality of life of the older citizens of Bangladesh.A qualitative descriptive approach was used in this study. A total of 27 In-Depth Interviews (IDIs) were conducted in a district in Bangladesh with older people between January and February 2020, where gender distribution was equal. Face-to-face interviews were conducted by trained and experienced interviewers regarding healthcare-seeking and accessibility, affordability, and healthcare coping strategy. Thematic analysis was conducted to analyse the data. It was found that the health condition of the older population is not satisfactory. Most of them had been suffering from several diseases such as benign tumor, chronic kidney disease, body aches, gastric ulcers for a longer period of time. The majority of the participants were suffering from multiple non-communicable diseases while diabetes and hypertension were the foremost of all diseases. This study provides insight into the challenges of managing healthcare services for older citizens in Bangladesh. Healthcare facilities were available, but high out-of-pocket payments, lack of caregivers, and time distance created a barrier to the service provision. The findings indicated that geriatric care policymakers and service providers should prioritize the older-friendly health infrastructures with affordable cost of treatment for the betterment of the health status of older citizens in Bangladesh.

A comparative study on treatment seeking behaviour of geriatric population in rural and urban areas of district Kanpur, Uttar Pradesh

Background: Aging is a complex and universal life process. Treatment seeking behaviour in elderly is affected by socio-economic factors and by affordability, availability and accessibility of healthcare. Objectives: To study treatment-seeking behaviour of the study subjects. To compare treatment seeking behaviour among rural and urban study subjects. Methods: This was a cross-sectional study conducted in the Kanpur district. Selection of villages in rural and mohallas in urban areas was done using a multistage random sampling technique. A total of 600 subjects were studied, including 400 from urban areas and 200 from rural areas. Elderly persons>60 years of age, both males and females were included in the study. Results: Overall, out of 600 study subjects, 59.8% were taking treatment in rural areas and in urban areas 77.6% were taking treatment. In urban areas, more females availed treatment compared to rural areas. Majority of study subjects (56.5%) sought treatment from a government hospital. Only 36% subjects had health insurance. Conclusion: In Urban areas more subjects availed treatment as compared to rural areas. Majority of subjects sought treatment from government health facilities. Lack of financial support and long waiting time were major reasons for not availing health care.

Health care services: Utilization and perception among elderly in an urban resettlement colony of Delhi

Context:

Health care utilization informs us about the utility of services which are available. We have a paucity of studies related to health care utilization among elderly in India.

Aims:

The aim of this study is to find out utilization of health care services by elderly (≥60 years), pattern, factors associated with, and perception of the elderly population regarding facilitators and barriers for the same.

Settings and Design:

A community based cross-sectional, observational study was conducted in a resettlement colony of East Delhi.

Materials and Methods:

A pretested, semi-structured, and interviewer-administered questionnaire was used. Duration of data collection was November 2018 to January 2020.

Statistical Analysis Used:

For quantitative variables, mean, median, proportion, Chi-square test, binary logistic regression using Statistical Package for the Social Sciences (SPSS), and for qualitative variables thematic analysis were done.

Results:

The study included 288 study participants. Although utilization of health care services in last 15 days among elderly is 90%, it was also found that 69% of the elderly consulted a licensed medical practitioner. A private facility was visited by 58% of the study participants. Female gender (OR: 1.97; P = 0.02), religion as Hindu (OR, 2.09; P = 0.04), and marital status “single” (OR, 1.8; P = 0.04) were observed to be significant predictors of health care utilization. The participants expressed less waiting time, cashless facility for visits, availability of an accompanying person, behavior of staffs work as facilitators for utilization of services.

Conclusions:

Considering the unique characteristics of this age group, a shift from facility to community-based approach may be considered. Efforts may be made to create elderly friendly health facilities.

Utilization of health care services by elderly for respiratory diseases including TB - Challenges

Progressive functional decline of all body organ systems in association with decreased immunity makes elderly vulnerable to all types of diseases including respiratory diseases. Advances in medical fields have resulted in increasing proportion of elderly globally. Healthcare demands of elderly population are complex. Provision of healthcare services for this continuously increasing population subgroup & ensuring their adequate utilization is full of challenges. These are demographic, socioeconomic, financial, physical accessibility, quality of healthcare services, attitudinal & transportation related. Large size of this subgroup with special healthcare needs in context of limited available resources of middle income country like India is the biggest challenge. Poor educational status & socioeconomic condition of Indian elderly, dependence on family, absence of formal social security & healthcare security complicates situation further. Condition of elderly females is particularly worse. In view of poor physical ability with often associated physical disability makes accessibility of healthcare services also significant factor. Overcoming negative attitudinal factors prevalent in Indian elderly & make them utilize available healthcare services is another huge challenge. Quality of healthcare services in form of availability of required expertise & equipments, attitude of healthcare providers towards elderly patients & convenience in utilization of these services also play an important role. Special provisions in TB control program for elderly in view of their complex needs, high prevalence, morbidity & mortality are also required.

Determinants of rural-urban differential in healthcare utilization among the elderly population in India

Background

Population aging poses a demographic burden on a country such as India with inadequate social security systems and very low public investment in health sector. This challenge of accelerated demographic transition is coupled by the rural-urban disparity in access to healthcare services among the elderly people in India. An important objective of India’s National Health Policy (2017) is to “progressively achieve universal health coverage” which is posited upon mitigating the sub-national disparity that necessitates identifying the drivers of the disparity for targeted policy intervention. This study, therefore, makes an attempt towards the exploration of the prominent contributory factors behind the rural-urban gap in utilisation of healthcare among the older population in India.

Methods

The analysis has been done by using the unit level data of Social Consumption: Health (Schedule number 25.0) of the 75th round of the National sample Survey conducted during July 2017–June 2018. Two binary logistic models have been proposed to capture the crude and the adjusted association between health seeking behaviour and place of residence (rural/ urban). To compute the group differences (between rural and urban) in the rate of healthcare utilization among the elderly population in India and to decompose these differences into the major contributing factors, Fairlie’s decomposition method has been employed.

Results

The logistic regression models established a strong association between place of residence and likelihood of healthcare utilisation among the Indian elderly people. The results of the Fairlie’s decomposition analysis revealed considerable rural-urban inequality disfavouring the rural residents and health care utilisation was found to be 7 percentage points higher among the older population residing in urban India than their rural counterparts. Level of education and economic status, both of which are indicators of a person’s Socio-Economic Status, were the two major determinants of the existing rural-urban differential in healthcare utilisation, together explaining 41% of the existing rural-urban differential.

Conclusion

Public health care provisions need to be strengthened both in terms of quality and outreach by way of greater public investments in the health sector and by building advanced health infrastructure in the rural areas. Implementation of poverty alleviation programmes and ensuring social-security of the elderly are also indispensable in bringing about equity in healthcare utilisation.

Prevalence of chronic morbidities and healthcare seeking behavior among urban community dwelling elderly population residing in Kalyani Municipality area of West Bengal, India

Introduction:

Demographic transition has resulted in higher proportion of elderly population in every community. The pattern of chronic morbidity along with healthcare seeking behavior and factors associated with it are important for implementation of national health policies targeted toward elderly population.

Methods:

A community based cross-sectional study was done including 457 urban dwelling elderly population of Kalyani Municipality area of West Bengal. Sociodemographic details, profile of chronic morbidities, and healthcare seeking behavior for chronic morbidities were studied using a pretested semi structured questionnaire.

Results:

The average education and financial independence were high among study participants. The prevalence of chronic morbidities was 82.3% and hypertension was the most common morbidity in both male and female. Around half of the individuals with chronic morbidities (57.7%) sought healthcare advice at least once in last 6 months. Most of the study participants preferred private healthcare setup and allopathic system of medicine. Females have been found to have higher treatment seeking behavior than males in logistic regression.

Conclusion:

We found hypertension and diabetes were more prevalent in the study population. Higher financial independence and education among study participants might have influenced the healthcare seeking behavior, which was mainly from private setup. Implementation of national health policies for elderly has to be accelerated in acceptable ways to promote health among elderly.

Self-Reported Morbidity and Health-Seeking Behavior and its Predictors Among a Geriatric Population in Western Ethiopia: Community-Based Cross-Sectional Study

Background

Planning for health care services provision depends on the morbidity profile, health-seeking behavior (HSB), and its predictors. Thus, this study aimed to identify the level of self-reported morbidity, HSB and its predictors.

Patients and Methods

A community-based cross-sectional study was conducted among the geriatric (≥60 years) population in West Shoa Zone. A multi-stage systematic sampling technique was employed to select the study participants. After testing for collinearity, variables with p-value <0.25 on binary logistic regression were entered into backward multivariate logistic regression analysis with statistical significance at p-value <0.05.

Results

With a response rate of 98%, 779 study participants were recruited. The median (IQR) age of the respondents was 70 (70–78) years. Five hundred eighty-four (3/4) of the study participants reported that they experienced morbidity at least once in the year before interview. Of 584 study participants, 53.9% had poor HSB. Living in village (p-value = 0.034), being housewife (p-value = 0.048), wealth index [being rich (p-value = 0.033), being in moderate economic status (p-value= 0.001), and being poor (p-value= 0.049) relative to richest], being head of polygamous household (p-value= 0.019), non-smoker (P-value = 0.012), not having community-based health insurance coverage (CBHI) (p-value< 0.0001), having ≤3 times number of illness (p-value <0.0001), self-medication (p-value < 0.0001), not having hypertension (p-value=0.016), not having diabetes mellitus (DM) (p-value=0.012), and not having oro-dental problem (p-value= 0.043) were positively associated with poor HSB. Nevertheless, self-perceived mild severity of illness (p-value= <0.0001), good health status (p-value= 0.001), and not having musculoskeletal problem (p-value< 0.0001) were negatively associated with poor HSB.

Conclusion

There was a high prevalence of self-reported morbidity and poor HSB. There should be an effort to improve the HSB and CBHI utilization of the geriatric population by all stakeholders. Moreover, modifiable predictors of HSB needs to be improved.

Exploring socioeconomic inequalities in the use of medicinal herbs among Iranian households: evidence from a national cross-sectional survey

Background

Association between socioeconomic status and medicinal herbs (MH) are rarely documented in Iran. Our goal was to measure and decompose socioeconomic inequalities in MH use among Iranian households.

Methods

The data used in this cross-sectional study were extracted from the 2018 Household Income and Expenditure Survey (HIES) (N = 38,859). Data on MH use, age, gender, and education status of the head of household; a constructed wealth index of household (as a proxy for household’s socioeconomic status); and place of residence (urban or rural) were obtained from the survey. Publicly available province-level data on Human Development Index (HDI) were obtained from the Institute for Management Research at Radbound University. We used the concentration curve and the normalized concentration index (C_n) to measure the magnitude of socioeconomic inequalities in MH among Iranian households. The C_n was decomposed to identify the main determinants of socioeconomic inequalities in MH in Iran.

Results

The overall prevalence of MH use among Iranian households was 4.7% (95% confidence interval [CI]: 4.5 to 4.9%) in the last month before data collection. The C_n for MH use for the whole of samples was 0.1519; 95% CI = 0.1254 to 0.1784; suggesting a higher concentration of MH use among the households with high socioeconomic level. The decomposition analysis indicated that the main contributing factors to the concentration of MH use were the economic status of households, development status of the province, and education level of the household head.

Conclusions

This study demonstrated that MH use is more concentrated among socioeconomically advantaged households in Iran and its provinces. This finding might contrast with the widespread belief that wealthy and socioeconomically advantaged populations, compared to low SES groups, tend to seek disproportionately more modern medical treatments and medications than MH. Understanding the factors affecting MH use, socioeconomic inequality in use of MH and its determinants provide an opportunity for health policymakers to design effective evidence-based interventions among providers and consumers of MH.

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home

Objectives This study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes. Methods The non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique. Results The neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found. Conclusions The findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

Untreated morbidity and treatment-seeking behaviour among the elderly in India: Analysis based on National Sample Survey 2004 and 2014

The changing demographic structure in India and worldwide accompanies with it a gamut of problems and opportunities. According to the Census of India, the proportion of elderly in the overall population rose from 5.6 per cent in 1961 to 8.6 per cent in 2011 and is expected to rise to 20 per cent in 2050. Considering the consequent growing challenges in healthcare the main aim of the study is to find essential determinants contributing to untreated morbidity among the elderly. Also, the paper examines treatment-seeking behaviour for infectious and chronic diseases among the elderly in India. Data from the 60th and 71st round of National Sample Survey Organization was used for the analysis. Relative differences were calculated along with logistic regression to study the objectives and the heckprobit model was used to carve out the treatment-seeking behaviour among the elderly in India. It was found that the overall decrease in relative decadal difference was 41% for untreated morbidity. In both the rounds, the elderly living below the poverty line had 42% and 50% more likelihood of untreated morbidities respectively in comparison to elderly not living below the poverty line. The study indicates that elderly who were living with a spouse in comparison to those living alone had less likelihood to have untreated morbidities. Also, elderly from rural areas and having lower levels of education had higher likelihood of untreated morbidity. Similar inequalities were observed in treatment-seeking behaviour as well, where it was found that elderly belonging to lower socio-economic status were less likely to seek treatment. Linking the results from the heckprobit model this study provides the evidence that social and economic factors play a significant role in affecting both untreated morbidity and treatment-seeking behaviour of elderly in India.

Gender prevalence of cardiovascular diseases in the geriatric population of India: A meta-analysis using R

BACKGROUND

Population ageing is an important challenge for developed as well as developing countries due to the downward trends in mortality rates. The elderly population is increasing worldwide. Cardiovascular diseases (CVDs) are one of the most common diseases in the geriatric population. These diseases involve the heart or blood vessels and include hypertension, rheumatic heart disease, heart failure, and heart attack. An estimated 17.7 million people in India will die from CVDs representing 31% of all global deaths.

AIM

To perform a systematic review and meta-analysis of the gender prevalence of CVDs in the geriatric population of India.

METHODS

In the present study, we searched databases such as Google Scholar, PubMed and MEDLINE from the year 2003 to 2019 to identify the prevalence of CVDs in the Indian geriatric population. A meta-analysis was conducted using the statistical software R version 3.4.3 and the random effect model was used to determine the pooled estimate of the prevalence of CVDs in the geriatric population of India along with the 95% confidence interval rather than using the fixed effect model. The random effect model takes into consideration the heterogeneity across the various studies.

RESULTS

The prevalence of CVDs in the Indian geriatric population was determined in 6586 male subjects from 32 studies and 8164 female subjects from 32 studies, respectively. The overall prevalence of CVDs in the Indian geriatric population was 36.6% (95%CI: 31.9%-41.3%). In addition, calculation of the various heterogeneity statistics (Cochran’s Q = 3836.85, I² = 98.6%, P < 0.0001) indicated heterogeneity in the prevalence of CVDs in the elderly Indian population in these studies. The prevalence of CVDs in elderly males was 38.0% (95%CI: 33.0%-43.0%) and the prevalence of CVDs in elderly females was 40.9% (95%CI: 35.5%-46.2%).

CONCLUSION

The results indicate that the prevalence of CVDs in the female geriatric population was relatively higher than that in the male geriatric population. Policy makers must take immediate steps to prevent CVDs and improve geriatric health care services in India.

Self-reported health problems, health care seeking behaviour and cost coping mechanism of older people: Implication for primary health care delivery in rural Bangladesh

BACKGROUND

Optimum utilization of primary health care system by older people is a challenge for every low and middle income country. Little is known about self reported health problems, health care seeking behaviour and cost coping mechanism of older people in developing countries.

OBJECTIVES

This study aimed to measure self-reported health problems, health care seeking behaviour and expenditure coping mechanism of older people, and to describe its implication for primary health care delivery in rural Bangladesh.

METHODOLOGY

It was a cross sectional study. In total, 362 older people were enrolled who sought health care preceding the last month of the interview. Descriptive and bivariate data analysis along with proportion test (z test) was carried out.

RESULTS

The most frequent self-reported health problems were fever (43.8%) followed by physical pain (15.2%). More than half of the respondents (57.5%) had a second health problem. Only one third (33.8%) visited qualified health providers having minimum western health or medical training from government approved authority. More than half (54%) of the older people spent for health care out of pocket from their own. Only 2% older people sold their assets or took loans to meet their health care. 36% older people thought that they could afford to pay for health care in future.

CONCLUSIONS

The findings of this study will help in developing primary health care policy for older people in rural Bangladesh and similar settings in South Asia.

The Social Determinants of Healthcare Access for Rural Elderly Women - A Systematic Review of Quantitative Studies

Objective:

This review aimed to explore and analyze the social determinants that impact rural women’s aged 60 years and older healthcare access in low or middle income and high income countries.

Methods:

Major healthcare databases including MEDLINE and MEDLINE In-Process, PsycINFO, PubMed, ProQuest, Web of Science, CINAHL and ERIC were searched from April 2016 to August 2016 and a manual search was also conducted. A rigorous selection process focusing on the inclusion of rural elderly women in study population and the social determinants of their healthcare access resulted in 38 quantitative articles for inclusion. Data were extracted and summarized from these studies, and grouped into seven categories under upstream and downstream social determinants.

Results:

Prevailing healthcare systems in combination with personal beliefs and ideas about ageing and healthcare were identified as significant determinants. Socioeconomic and cultural determinants also had a statistically significant negative impact on the access to healthcare services, especially in developing countries.

Conclusion:

Potentially, improvements to healthcare access can be achieved through consideration of rural elderly women’s overall status including healthcare needs, socioeconomic determinants and cultural issues rather than simply establishing healthcare centers.

Morbidity pattern and health-seeking behavior of elderly in urban slums: A cross-sectional study in Assam, India

Background

Elderly population in India is increasing fast which indicates a growing share of population with more special needs for health and support. Understanding the morbidities and health-seeking behavior of elderly is essential for strengthening geriatric health-care services delivery.

Objectives

The objective of this study was to study the morbidity profile of elderly in urban slum areas and assess their health-seeking behavior.

Methodology

A cross-sectional study was conducted in urban slums of Jorhat district of Assam, among 125 elderly selected by simple random sampling.

Statistical Analysis Used

The statistical analysis was performed by Chi-square and proportions.

Results

The most common morbidity found was arthritis (70.4%) followed by visual impairment (58%). Majority (83.7%) were seeking treatment for their health problems. Among those elderly who did not seek treatment, the most common reasons given were "lack of money" (81.2%) and "not feeling necessary to go to doctor as conditions were age related" (62.5%).

Conclusions

More than two-third of slum-dwelling elderly in the present study were suffering from chronic morbidities; a few could not afford proper health care due to lack of money and self-medication practices were prevalent among some. This stresses the need to provide suitable health facilities and affordable health care to the elderly in slum areas to ensure their active aging. Living arrangement of the elderly was found to have significantly influenced their health-seeking behavior. Strategic implementation of policies focusing on the problems and beliefs of slum-dwelling elderly which prevent them from seeking healthcare is the need of the hour.

Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa

Background

Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE).

Method

A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as THM use. Logistic regression was also employed to investigate possible associations between reported conditions and THM use or medical pluralism.

Results

Within the study sample, 72 % self-reported an NCD. Of those with self-reported NCDs, 46 % had one, and 54 % had two or more NCDs. Those with NCDs usually visited public clinics (80 %), relied on doctors (90 %) and nurses (85 %) for health information, and mostly used conventional medicine (CM) to manage high blood pressure (81 %). About 30 % of those with NCDs indicated using THM, of whom 29 (53 %) reported practicing medical pluralism. Participants with dental problems (OR: 3.24, 95 % CI: 1.30–8.20), headaches (OR: 2.42, 95 % CI: 1.24–4.94), heart burn (OR: 2.30, 95 % CI: 1.18–4.48) and severe tiredness (OR: 2.05, 95 % CI: 1.08–3.99) were more likely to use THM. Anxiety and allergies increased the likelihood to practise medical pluralism by five and 20 times, respectively.

Conclusion

Self-reported NCD with co-morbidities was prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. THM use was not very common. However, among those who used THM, medical pluralism was prevalent. Family history was the most common reason for THM use, with many THM patrons utilizing these for treatment of a health condition. Older black women with anxiety and allergies were more likely to practise medical pluralism.

Assessment of morbidity pattern, quality of life and awareness of government facilities among elderly population in South India

Background:

This study was done to assess the determinants of morbidity pattern, quality of life (QoL) and awareness of elderly about various government schemes and social security legislations.

Materials and Methods:

Data was collected by house to house survey among participants aged 60 years and above using a structured interview schedule. The QoL was assessed using Kannada version of WHOQOL-BREF instrument following language validation.

Results:

Mean age of 206 participants was 69.6±6.7 years. Half of them were males and majority were graduates 54 (26.2%). Morbidity was present among 194 (94.2%) participants (95% CI 89.5–98.9%), most common being hypertension 96 (46.6%). Morbid conditions were seen more among less educated (P = 0.007). Only 68 (33%) were under medical insurance coverage, 17 (8.3%) were under old age government pension and 74 (35.9%) were under retirement pension scheme. Social relationships, psychological health and environmental domain scores were associated with socio-economic status. Social relationship domain score was significantly better among well educated participants and those without morbidities. Level of ambulation was significantly associated with QoL scores in all domains (P < 0.001). Majority of the participants 132 (64.1%) had moderate level of awareness about government facilities for senior citizens. Awareness level was significantly better among males (P < 0.001), well educated (P < 0.001), better socio-economic status respondents (P < 0.001) and those currently working (P = 0.026).

Conclusion:

Health status of elderly needs improvement which would also improve their QoL. Awareness about various government schemes needs to be enhanced to improve its utilization. The results of this study are expected to help policy makers in planning comprehensive services for elderly residing in this area.