Community Based Appraisal of Healthcare Service Utilisation and Determinants of Health Seeking Behaviour among the Elderly Population of Rural Western Maharashtra

Introduction: To mitigate an inevitable phenomenon of population ageing, which has impact on nation’s development as well as on quality of life of population, health seeking behaviour and health service utilisation need to be increased, especially in rural areas.

Aim: To assess health seeking behaviour, identify hurdles and measure health services utilisation.

Materials and Methods: A community based observational descriptive cross-sectional study was conducted with 210 elderly population (60 years of age and above) to assess health seeking behaviour and to measure health service utilisation for the period from October 2020 to October 2021, in rural area of Tasgaon block of Sangli district of Maharashtra by Department of Community Medicine, Government Medical College, Miraj, Maharashtra, India. A pretested, prevalidated, semi-structured proforma and interview schedule were used to collect information. Descriptive statistics along with Chi-square test and Binary logistic regression were used as inferential statistical analysis. The p-value to be significant at p<0.05.

Results: Out of total 210 participants, 48.09% and 51.91% were males and females respectively with male to female ratio of 0.93:1. Mean ages of males and females were 63.85 and 65.23 years respectively.Out of total 210 participants, 82% of participants had atleast one chronic morbidity at the time of study. Musculoskeletal morbidities were most common (46.67%). Among morbid participants, 56% utilised government health facility. Health service utilisation rate was 75.86%. Lack of enough money was most common reason (76.19%) for non utilisation of health services. Gender, educational level, residential arrangements and socio-economic class showed statistically significant association with appropriate or inappropriate health seeking behaviour. About 61% participants showed appropriate health seeking behaviour. The odds of having inappropriate health seeking behaviour were 7.76 and 10.19 times greater for middle class and lower class as opposed to upper class, respectively. Illiterates had 17.53 times higher odds to seek health inappropriately.

Conclusion: Quality of health seeking behaviour can be improved by narrowing gender gap, increasing literacy rate and giving social assistance to elderly persons. It is an important need of hour to pay more attention to age related issues and promote holistic approach to deal with ageing society.