Healthcare Utilization and Its Determinants Among the Elderly Population in Rural North India: A Community-Based Cross-Sectional Study

Abstract

Background: Utilization of healthcare services becomes increasingly important with advancing age because of multimorbidity, functional decline, and the need for preventive as well as chronic care. Elderly people in rural settings often face barriers related to awareness, accessibility, dependency, and socioeconomic disadvantage.
Objectives: To assess healthcare utilization among elderly people and identify its determinants in a rural district of North India.
Methods: This community-based cross-sectional study was conducted among elderly individuals aged 60 years and above in rural North India. A multistage random sampling technique was used to recruit 384 participants. Information was collected using a pretested semi-structured questionnaire. Descriptive analysis and chi-square test or logistic regression were planned to identify determinants of utilization.
Results: Among 384 participants, 53.4% were males and 46.6% females. Most participants were in the 60 to 65 years age group (64.3%), 65.9% were married, 60.9% belonged to the lower socioeconomic class, and 64.1% were illiterate. Awareness of healthcare services was reported by 93.8% of participants. Regarding healthcare utilization, 31.5% visited a healthcare provider annually, 25.5% visited every few years, and 42.7% never visited a healthcare provider. Chronic morbidity was present in 40.6% of participants, and 31.5% were taking medications for chronic morbidity. Healthcare utilization was significantly associated with socioeconomic status (p = 0.021), type of family (p <0.001), and chronic morbidity status (p = 0.004) and awareness of healthcare services (p <0.001).
Conclusion: Healthcare utilization among the elderly was independently associated with awareness of healthcare services, family structure, and chronic morbidity. Strengthening awareness, family-based support, and geriatric outreach services may improve healthcare utilization among elderly persons in rural settings.