Abstract
ObjectiveThe objective of this study was to evaluate the factors associated with the health status of older Chinese people living in the community, in order to inform strategies to expand access to healthcare.MethodsTwo-phase stratified cluster sampling was applied; 2000 older people participated in this study. Face-to-face interviews were conducted in Shanghai between June and August, 2011. Descriptive analysis was used to examine the respondents’ characteristics. Based on Andersen’s healthcare utilization model, a chi-squared test and multiple logistic regression were performed to examine the influences of predisposing, enabling, need, and contextual factors on healthcare utilization.ResultsWe found that 44.5% of the older people in the sample had good self-reported health status, while 12.8% were poor, 14.5% had visited hospitals or clinics as outpatients in the previous two weeks, and 16.5% had been hospitalized in the previous year. Logistic regression analysis revealed that outpatient health services were more likely to be used by women and those whose income was from friends or social relief, who had poor to good self-reported health status, who were experiencing declining health, who engaged in volunteer activities, and who had chronic diseases. Meanwhile, hospitalization was more likely among those in the older age groups, those with pension income, living in outer suburbs, with poor self-reported health status, experiencing difficulty with activities of daily living and outdoor activities, or having a chronic disease.ConclusionsThe results showed the impact of economic status, health status, demographic and social characteristics, and other factors on the health service utilization of elderly people living in the community in Shanghai. Need variables were the strongest predictors of health service use, although contextual factors also contributed.
Highlights
An aging society is one where more than 10% of the population is over 60 years old and/or 7% are over 65 [1]
We found that 44.5% of the older people in the sample had good self-reported health status, while 12.8% were poor, 14.5% had visited hospitals or clinics as outpatients in the previous two weeks, and 16.5% had been hospitalized in the previous year
Logistic regression analysis revealed that outpatient health services were more likely to be used by women and those whose income was from friends or social relief, who had poor to good self-reported health status, who were experiencing declining health, who engaged in volunteer activities, and who had chronic diseases
Summary
An aging society is one where more than 10% of the population is over 60 years old and/or 7% are over 65 [1]. According to statistics published by the WHO, the percentage of the global population aged 60 and over was 11% by the end of 2011, while that in China was 13% [2]. According to the Shanghai Bureau of Statistics, the city had a population of 14.50 million people registered as living in households by the end of 2016, of whom 31.59% were aged 60 and over, with this percentage increasing annually [3]. This rapidly aging population poses significant challenges for healthcare [4]. There is growing recognition globally of the need to evaluate how healthcare services are utilized, and how healthcare systems might best be enhanced to meet the health needs of an aging population [7]
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