Title:Predictors of Healthcare Utilization Among Older Adults with Moderate
to Severe Cognitive Limitations in Ghana: A Cross-Sectional Analysis of
the WHO Study on Global Ageing and Adult Health (SAGE) Wave 1
Volume: 19
Issue: 8
Author(s): Baozhen Dai, Ebenezer Larnyo*, Abigail Larnyo, Jonathan Aseye Nutakor, Edwina Naa Amerley Amarteifio, Yaw Frimpong and Stephen Addai-Dansoh
Affiliation:
- Department of Health Policy and Management, School of Management, Jiangsu University, Zhenjiang, Jiangsu Province
212013, China
Keywords:
Healthcare utilization, healthcare seeking-behavior, older adults, cognitive decline, Andersen's behavioral model, Ghana.
Abstract:
Background: 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.
Objective: This study examines the predictive factors of healthcare-seeking behavior among older
adults with moderate-to-severe cognitive limitations in Ghana.
Methods: 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: 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.
Conclusion: 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.