Outpatient health service utilization and associated factors among Iranian older adults: based on Andersen’s behavioral model

Abstract

ABSTRACT The aim of this study was to investigate the prevalence of the utilization of outpatient health services (OHSU) and the related factors among community-dwelling older adults in Tehran, Iran. A cross-sectional study was conducted from October to December 2019 among 1280 older adults aged 60 ≥, living in Tehran. Logistic regression analysis was used to determine the association between factors identified in the framework used in this study (predisposing factors, enabling factors, and need-related factors) and utilization of OHS in the previous month. SPSS Statistics (version 23.0; IBM) was used to analyze the data. The mean age of participants was 70.9 years. The prevalence of OHSU in the previous month was 90.21%. Overall, 59.6% reported good health status and 93.6% had at least one chronic disease. 32.8% of the older adults were satisfied with receiving the latest health services. Multiple logistic regression analyses revealed that the use of health services was higher in males, those with high monthly incomes, those living with a partner, and older adults with higher education. There was a significant association between not using substances and a lower odds of OHSU. Living alone had a significant association with lower odds of health service utilization among older adults. Thus, health care policies need to focus on social support and access to health services for older adults who live alone. Identification and targeting interventions toward older adults who do not utilize health services should be considered by policy makers and the health care system.