Factors affecting access to health services by older adults in an urban community in Thailand: a cross-sectional study.

Abstract

Background: The impending rapid change in Thailand's older population has many important implications for health policy, especially older adults' health problems, which are major cause of them accessing health services. This study aimed to study factors affecting access to health services for older adults in urban communities in Thailand, as well as performing a situational survey of health service utilization. Methods: This cross-sectional study included 886 older adults from four different neighborhoods (slum, city, suburban, and community building). Data were collected using an interview questionnaire. Information about health service variables were extracted and followed the five dimensions of accessibility by Penchansky & Thomas: availability, accessibility, accommodation, affordability and acceptability. Data were analyzed using percentage mean and standard deviation (SD). Analysis of factors affecting access to health service was performed using Logistic regression. Results: The utilization of health services was high among five dimensions. There is no significant difference among other dimensions statistically from all neighborhoods. Only the acceptability dimension with notable difference (p=0.003), city neighborhood has the lowest acceptability dimension (mean 4.0, SD.=0.62), while community building has the highest one (mean 4.3, SD.=0.55). Factors affecting older adults access to health services were using health insurance rights for health care service, and concern about the necessity of health care. Conclusions: Encouraging older adults to change their health insurance rights to the nearest hospital and promoting the provision of holistic health information, which will support older adults in accessing more health services to improve their health outcomes.