Chronic disease profile, health utilization and self-reported financial situation of older people in rural South Africa

Abstract

Background: Chronic diseases are more prevalent among older people. These illnesses require seeking continuous medical services which oftentimes have spill-over effects on the financial situation of individuals and households. Objective: To describe the chronic disease profile, health utilization and self-reported financial situation of older people in a rural population. Methods: Cross-sectional data from South Africa Wellbeing and Older People Study (WOPS)-wave 2 was utilized for this study. The survey included 519 respondents and was carried out between April 2013 and August 2013. Descriptive statistics was used to report respondents’ socio-economic characteristics, chronic disease profile, health utilization patterns, hospitalizations and access to medical and non-medical financial aid. Chi square test was conducted to examine the factors associated with chronic diseases and self-reported financial situation at 5% level of confidence. Results: The mean age of respondents was 62 years. Of the respondents, 259 (50%) had hypertension and 122 (24%) had arthritis, twenty-two (4%) had stroke, 43 (8%) had diabetes, 25 (5%) hade asthma, 10 (2%) had heart disease and 6 (1%) had cancer. Following the experience of a health problem, 119 (46.67%) adopted self-medication and 36 (14.12%) consulted traditional healer. Four hundred and fifty-four (97.63%) respondents received no financial aid for buying drugs and paid out-of-pocket. Also, 452 (97.41%) had no access to financial aid to pay for hospital bills. Risk factors like tobacco use (χ2 =6.77, p=0.009) and alcohol consumption (χ2 = 8.90, p= 0.003) were also associated with hypertension. Also, being hospitalized in the last 1 year (χ2 = 8.15, p=0.017) was associated with whether households’ financial condition got better, remained the same or got worse. Having chronic disease (χ2 = 7.68, p= 0.022) was similarly significantly associated with self-reported financial situation. Conclusions: The burden of chronic disease was high among older persons in this study. The study provided evidence that suggests that unearned income such as government grants and transfers as well financial supports from individuals’ families and acquaintances can provide some form of insurance against worsening financial condition among older people.