Kshatri Jaya Singh, Rehman Tanveer, Janssen Daisy J A, Shenkin Susan D, Palo Subrata Kumar, Pati Sanghamitra
Indian Council of Medical Research- Regional Medical Research Centre, Bhubaneswar, 751023 India.
Maastricht University, Maastricht, The Netherlands.
Discov Public Health. 2025;22(1):282. doi: 10.1186/s12982-025-00686-4. Epub 2025 May 20.
With an increasing number of older people across low and middle income countries such as India, longitudinal observational research is required to understand the processes of aging, care seeking behaviours and outcomes in such groups. As most of the older adults in such regions live in rural areas with limited resources, and with no such cohorts available to carry out such studies, we have establied a first of its kind geriatric rural cohort in eastern India. This study describes the profile of a large cohort of 18,389 rural older adults, aged 50 years or more, that was built within a Health, Demography and Environment Surveillance System (HDESS). The study primarily focuses on profiling older adults' sociodemographic and health characteristics, as well as their healthcare-seeking behavior patterns. We use exploratory regression analysis to understand factors influencing care-seeking preferences. We use R software packages for analysis and data management. The entire population of HDESS is 76,391 which has been establihed in 50 villages of Tigiria, Odisha state in eastern India, between 2021 and 2022. This cohort provides a valuable longitudinal platform for studying aging processes, chronic disease progression, and intervention implementation. Self-reported prevalence of chronic conditions and multimorbidity was 9.5%, with diabetes (10.6%) and hypertension (22.0%) the most common ones. Most rural older adults, irrespective of their wealth status, preferred public to private healthcare facilities (91%) for either mild illness, general care or emergency/severe illness. To reduce informal healthcare seeking behaviour (8.3%) of older adults in rural India, services need to be available, but social factors must also be addressed. The DISHA-G cohort provides a unique longitudinal platform to study aging and healthcare-seeking behaviors in rural India. Key findings reveal significant reliance on public healthcare and significant informal care-seeking, influenced by insurance coverage and socioeconomic status, highlighting barriers to formal care. Policy initiatives should focus on expanding health insurance coverage, improving accessibility to public healthcare, and addressing socioeconomic barriers to reduce reliance on informal care among rural older adults.
The online version contains supplementary material available at 10.1186/s12982-025-00686-4.
在印度等低收入和中等收入国家，老年人数量不断增加，因此需要进行纵向观察性研究，以了解这类人群的衰老过程、就医行为及结果。由于这些地区的大多数老年人生活在资源有限的农村地区，且没有可供开展此类研究的队列，我们在印度东部建立了首个此类老年农村队列。本研究描述了在健康、人口统计学和环境监测系统（HDESS）中建立的一个由18389名50岁及以上农村老年人组成的大型队列的概况。该研究主要关注老年人的社会人口学和健康特征，以及他们的就医行为模式。我们使用探索性回归分析来了解影响就医偏好的因素。我们使用R软件包进行分析和数据管理。HDESS的总人口为76391人，于2021年至2022年期间在印度东部奥里萨邦蒂吉里亚的50个村庄建立。该队列提供了一个宝贵的纵向平台，用于研究衰老过程、慢性病进展和干预措施的实施。慢性病和多重疾病的自我报告患病率为9.5%，其中糖尿病（10.6%）和高血压（22.0%）最为常见。大多数农村老年人，无论其财富状况如何，在患有轻度疾病、一般护理或紧急/严重疾病时，都更倾向于选择公立而非私立医疗机构（91%）。为了减少印度农村老年人的非正式就医行为（8.3%），需要提供服务，但也必须解决社会因素。DISHA-G队列提供了一个独特的纵向平台，用于研究印度农村地区的衰老和就医行为。主要研究结果显示，受保险覆盖范围和社会经济地位的影响，对公共医疗保健存在显著依赖以及大量非正式就医行为，凸显了正规护理的障碍。政策举措应侧重于扩大医疗保险覆盖范围、改善获得公共医疗保健的机会以及消除社会经济障碍，以减少农村老年人对非正式护理的依赖。
在线版本包含可在10.1186/s12982-025-00686-4获取的补充材料。
