Determinants of access to healthcare by older persons in Uganda: a cross-sectional study

International Journal for Equity in Health

Research

Betty Kwagala¹  James Ntozi¹  Stephen Ojiambo Wandera² 

[1] Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda;Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda;Consortium for Advanced Research Training in Africa (CARTA cohort 2) Fellow at the African Population and Health Research Centre (APHRC), Nairobi, Kenya;

关键词: Africa;    Uganda;    Utilization;    Health care;    Health services;    Elderly;   

DOI  :  10.1186/s12939-015-0157-z

 received in 2014-10-24, accepted in 2015-02-24,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundOlder persons report poor health status and greater need for healthcare. However, there is limited research on older persons’ healthcare disparities in Uganda. Therefore, this paper aimed at investigating factors associated with older persons’ healthcare access in Uganda, using a nationally representative sample.MethodsWe conducted secondary analysis of data from a sample of 1602 older persons who reported being sick in the last 30 days preceding the Uganda National Household Survey. We used frequency distributions for descriptive data analysis and chi-square tests to identify initial associations. We fit generalized linear models (GLM) with the poisson family and the log link function, to obtain incidence risk ratios (RR) of accessing healthcare in the last 30 days, by older persons in Uganda.ResultsMore than three quarters (76%) of the older persons accessed healthcare in the last 30 days. Access to healthcare in the last 30 days was reduced for older persons from poor households (RR = 0.91, 95% CI: 0.83-0.99); with some walking difficulty (RR = 0.90, 95% CI: 0.83-0.97); or with a lot of walking difficulty (RR = 0.84, 95% CI: 0.75-0.95). Conversely, accessing healthcare in the last 30 days for older persons increased for those who earned wages (RR = 1.08, 95% CI: 1.00-1.15) and missed work due to illness for 1–7 days (RR = 1.19, 95% CI: 1.10-1.30); and 8–14 days (RR = 1.19, 95% CI: 1.07-1.31). In addition, those who reported non-communicable diseases (NCDs) such as heart disease, hypertension or diabetes (RR = 1.09, 95% CI: 1.01-1.16); were more likely to access healthcare during the last 30 days.ConclusionIn the Ugandan context, health need factors (self-reported NCDs, severity of illness and mobility limitations) and enabling factors (household wealth status and earning wages in particular) were the most important determinants of accessing healthcare in the last 30 days among older persons.

【 授权许可】

CC BY   
© Wandera et al.; licensee BioMed Central. 2015