Equity in the delivery of community healthcare to older people: findings from 10/66 Dementia Research Group cross-sectional surveys in Latin America, China, India and Nigeria
2011

Equity in Community Healthcare for Older People

Sample size: 17944 publication Evidence: moderate

Author Information

Author(s): Albanese Emiliano, Liu Zhaorui, Acosta Daisy, Guerra Mariella, Huang Yueqin, Jacob KS, Jimenez-Velazquez Ivonne Z, Llibre Rodriguez Juan J, Salas Aquiles, Sosa Ana L, Uwakwe Richard, Williams Joseph D, Borges Guilherme, Jotheeswaran AT, Klibanski Milagros G, McCrone Paul, Ferri Cleusa P, Prince Martin J

Primary Institution: King's College London, Institute of Psychiatry, Health Services and Population Research Department

Hypothesis

To assess the equity with which services are accessed and delivered among older people in low and middle-income countries.

Conclusion

Inequity in healthcare access was evident, particularly influenced by education and health insurance coverage.

Supporting Evidence

  • The proportion using healthcare services varied from 6% to 82% among sites.
  • Physical impairments and depression were positively associated with service use.
  • Dementia was inversely associated with healthcare service use.
  • Health insurance coverage was positively associated with service use in most sites.
  • Out-of-pocket expenses were a significant barrier to healthcare access.
  • Women were more likely to access community healthcare services than men.
  • Older people with higher education levels were more likely to use healthcare services.
  • Significant variation in service use was observed across different countries.

Takeaway

This study looked at how older people in different countries get healthcare and found that those with more education and insurance are more likely to get help.

Methodology

Population-based cross-sectional surveys were conducted in nine countries with participants aged 65 and over.

Potential Biases

Potential underreporting of healthcare utilization, especially among those with dementia.

Limitations

Self-reported data may be biased, and the findings may not be generalizable to all older populations.

Participant Demographics

Participants were aged 65 and over, with varying levels of education and socioeconomic status across different countries.

Statistical Information

P-Value

0.09

Confidence Interval

95% CI 1.26-1.49

Statistical Significance

p=0.09

Digital Object Identifier (DOI)

10.1186/1472-6963-11-153

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