Dai Baozhen, Larnyo Ebenezer, Larnyo Abigail, Nutakor Jonathan Aseye, Amerley Amarteifio Edwina Naa, Frimpong Yaw, Addai-Dansoh Stephen
Department of Labor and Social Security, School of Public Health, Southeast University, Nanjing, Jiangsu Province 210009, China.
Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu Province 212013, China.
Curr Alzheimer Res. 2022;19(8):585-605. doi: 10.2174/1567205019666220905153301.
As the number of older adults in Ghana keeps increasing, so does the prevalence of aging-related diseases and conditions that tend to lead to cognitive decline. However, knowledge on the predicting factors of healthcare utilization among older adults with cognitive limitations is still scarce.
This study examines the predictive factors of healthcare-seeking behavior among older adults with moderate-to-severe cognitive limitations in Ghana.
Based on Andersen's behavioral model of health service utilization, the study analyzed data from 3106 older adults with moderate to severe cognitive limitations in Ghana aged 50+ using Bivariate Probit Regression and the Heckman Selection Model.
Results showed that individuals who were aged 75+, living in urban settlements, educated, higher income levels and parents who had some level of education, pension benefits, and both mandatory and voluntary health insurance were more likely to seek inpatient care. Enabling resources such as the national health insurance scheme and other types of medical insurance, household income, pension benefits, and predisposition factors like education influenced outpatient and inpatient healthcare consumption for older adults with moderate to severe cognitive limitations but had little influence on the choice of healthcare facility except for health insurance.
Since the healthcare-seeking behavior of older adults with moderate-to-severe cognitive limitations is driven by an amalgamation of several internal and external factors, there is a need for policy change to understand and cautiously incorporate these factors into the decision to improve equitable access to healthcare services for these individuals, as not all sizes fit all in providing quality care for them.
随着加纳老年人数量不断增加，与衰老相关的、往往会导致认知能力下降的疾病和状况的患病率也在上升。然而，关于认知能力有限的老年人医疗保健利用的预测因素的知识仍然匮乏。
本研究调查加纳中重度认知能力受限老年人寻求医疗保健行为的预测因素。
基于安德森的卫生服务利用行为模型，该研究使用双变量概率回归和赫克曼选择模型，分析了来自加纳3106名年龄在50岁及以上的中重度认知能力受限老年人的数据。
结果显示，75岁及以上、居住在城市地区、受过教育、收入水平较高以及父母有一定教育程度、有养老金福利、同时拥有强制和自愿医疗保险的人更有可能寻求住院治疗。诸如国家健康保险计划和其他类型的医疗保险、家庭收入、养老金福利等促成资源，以及教育等倾向因素影响了中重度认知能力受限老年人的门诊和住院医疗消费，但除了医疗保险外，对医疗保健机构的选择影响不大。
由于中重度认知能力受限老年人的就医行为受多种内部和外部因素综合驱动，因此需要改变政策，以了解并谨慎地将这些因素纳入决策，从而改善这些人群公平获得医疗服务的机会，因为并非所有方法都适用于为他们提供优质护理。
