Outpatient Healthcare Utilisation among Elderly in Ambalappuzha North Panchayath, Kerala, India: A Cross-Sectional Study

Background: The rising elderly population in Kerala presents challenges in healthcare utilization due to factors such as accessibility, affordability, and availability. Many elderly individuals avoid seeking healthcare, and their satisfaction levels vary. This study aims to assess healthcare utilization among elderly residents of Ambalappuzha North Panchayath.

Objectives: Primarily, to examine healthcare utilization patterns among elderly individuals in Ambalappuzha North Panchayath. Secondarily, to find the factors associated with the non-utilization of healthcare. Additionally, we sought to explore the correlation between satisfaction with the outcome of care and the type of healthcare facility, as well as the association between the type of facility and the perceived level of explanation and respect received by patients.

Methods: A community-based cross-sectional study was conducted from October to November 2018 in Ambalappuzha North Panchayath. 500 elderly individuals aged 50 and above participated. Data were collected using a modified semi-structured SAGE questionnaire after obtaining informed verbal consent. The information encompassed demographics, healthcare utilization, quality, satisfaction, and reasons for not seeking healthcare.

Results: The majority of participants (41.4%) were aged 50-60, with 53.6% males and 46.4% females. 55.4% were above the poverty line. Public hospitals (66.2%) and clinics (10.8%) were commonly utilized. Hypertension (16.5%), acute conditions (15.4%), diabetes (12.5%), and chronic joint pain (12.4%) were prevalent. 91% of the participants regularly utilized healthcare. Reasons for not seeking healthcare included perceived lack of severity, affordability, and past negative experiences. The cost of visits was covered by their children by 45.72%. Satisfaction was expressed by 91.5% of users, with 86.7% reporting improved outcomes. Female respondents utilized more healthcare compared to males. A positive association was found between satisfaction, treatment outcomes, and type of facility. Provider explanation and perceived respect were more in the private sector.

Conclusion: The majority of elderly individuals in Ambalappuzha North Panchayath utilized healthcare, favoring the public sector. Hypertension, acute conditions, diabetes, and joint problems were common healthcare needs. Satisfaction correlated with treatment outcomes and the type of facility visited. Private sector providers demonstrated superior explanations and respect compared to the public sector. Future studies should focus on comparative studies across different regions and must delve deeper into socioeconomic factors of healthcare utilization.