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印度北阿坎德邦喜马拉雅山区农村老年人口的发病情况及医疗服务利用模式:一项横断面研究

Morbidity Profile and Healthcare Service Utilization Pattern Among Geriatric Population in the Rural Himalayan Region of Uttarakhand, India: A Cross-Sectional Study.

作者信息

Palepu Sarika, Bandyopadhyay Arkapal, Nandan Tumul, Singh Shradha

机构信息

Community Medicine, All India Institute of Medical Sciences (AIIMS) Kalyani, Kalyani, IND.

Pharmacology, All India Institute of Medical Sciences (AIIMS) Kalyani, Kalyani, IND.

出版信息

Cureus. 2023 Dec 5;15(12):e50000. doi: 10.7759/cureus.50000. eCollection 2023 Dec.

Abstract

OBJECTIVES

The increasing elderly population, along with their health problems, is a matter of concern, especially in the difficult terrains of the hilly Himalayan region of northern India. Hence, the present study was conducted to assess the healthcare-seeking behavior of the elderly and adherence to medication.

METHODS

The present community-based cross-sectional study was conducted on 250 elderly participants by a consecutive sampling method. Data were collected during the months of July 2021 to October 2021 after obtaining institutional ethical clearance. Bivariate logistic regression was done to assess factors associated with healthcare services utilization patterns and adherence to medications in chronic diseases. Significant factors were then analyzed with a multivariate logistic regression model. Variables with p-value <0.05 on multivariate analysis were considered statistically significant.

RESULTS

The mean age of the study participants was 67.2 (±8.09) years, and 52% were males. Chronic illness was diagnosed in 45.6% participants. Only 121 (48.4%) participants were aware of health insurance schemes among whom 95 (38%) were registered. Appropriate healthcare-seeking behavior for acute illness episodes was seen in 68.9% of participants. A government healthcare facility was the most preferred facility. Low adherence to chronic disease medication was seen in 41.2%. Participants registered under any health insurance scheme had higher adherence to medications (OR=0.36; 95% CI, 0.15-0.86; p-value=0.02).

CONCLUSIONS

The majority of the participants preferred government healthcare facilities. Registration under any health insurance scheme was found to significantly influence adherence to medications. Further qualitative studies can be of paramount importance in understanding the perspectives of the geriatric population in the study area.

摘要

目的

老年人口不断增加,以及随之而来的健康问题,令人担忧,尤其是在印度北部喜马拉雅山区地形复杂的地区。因此,开展本研究以评估老年人的就医行为和用药依从性。

方法

本基于社区的横断面研究采用连续抽样法对250名老年参与者进行。在获得机构伦理批准后,于2021年7月至2021年10月期间收集数据。进行双变量逻辑回归以评估与医疗服务利用模式和慢性病用药依从性相关的因素。然后用多变量逻辑回归模型分析显著因素。多变量分析中p值<0.05的变量被认为具有统计学意义。

结果

研究参与者的平均年龄为67.2(±8.09)岁,男性占52%。45.6%的参与者被诊断患有慢性病。只有121名(48.4%)参与者了解健康保险计划,其中95名(38%)进行了登记。68.9%的参与者在急性病发作时有适当的就医行为。政府医疗机构是最受欢迎的机构。41.2%的参与者慢性病用药依从性较低。在任何健康保险计划下登记的参与者用药依从性较高(OR=0.36;95%CI,0.15 - 0.86;p值=0.02)。

结论

大多数参与者更喜欢政府医疗机构。发现任何健康保险计划下的登记都对用药依从性有显著影响。进一步的定性研究对于了解研究地区老年人群的观点至关重要。

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