Assessment of health status, utilization, and out-of-pocket expenditure among the elderly in Ngestiharjo, Bantul, Yogyakarta

https://doi.org/10.22146/jcoemph.86497

Firdaus Hafidz(1*)

(1) 1Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: As the population ages, it is increasingly crucial to develop community-centered health interventions. This study aims to describe and assess sociodemographic information, health characteristics, health utilization, and out-of-pocket expenses among older people in Ngestiharjo Village, Bantul, Yogyakarta. It was part of an initiative to empower community health workers to understand and address the health needs of older people. Methods: A cross-sectional survey was conducted from April to July 2023 involving 330 participants, with a targeted sample size of 356 elderly individuals. Data on sociodemographics, health status, health utilization, and expenditure were collected through interviews with older people or their companions. Results: Preliminary data showed that most participants were female (58.77%), married (64.91%), and primarily received health information from health workers (47.37%). Hypertension and joint and bone diseases were prevalent, with 16.67% likely experiencing depression. 11.4% of the respondents were hospitalized in the past year, with an average of 2.15 hospitalizations. Private hospitals (69.23%) were the most common healthcare facilities used for hospitalization, and 76.92% consistently utilized health insurance. The average out-of-pocket expenditure for hospitalization was 437,500 IDR. Community health centers (36.36%) and private hospitals (45.45%) were predominantly used for outpatient care, and 77.27% always used health insurance. The average out-of-pocket expenditure for outpatient care was 126,200 IDR. Conclusions: The study underscores the importance of empowering community health workers to effectively disseminate health information, fortify integrated health posts, manage common health issues, and tackle barriers to healthcare utilization and expenditures among older people.


Keywords


elderly; health utilization; out-of-pocket expenditure; community health; community health workers; Ngestiharjo, Bantul, Yogyakarta

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References

1. BPS. Statistik Penduduk Lanjut Usia 2021. Badan Pusat Statistik, https://www.bps.go.id/publication/2021/12/21/c3fd9f27372f6ddcf7462006/statistik-penduduk-lanjut-usia-2021.html (2021, accessed July 4, 2023).

2. Naghavi M, Abajobir AA, Abbafati C, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1151–1210.

3. Barber RM, Fullman N, Sorensen RJ, Bollyky T, McKee M, Nolte E, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. The lancet. 2017 Jul 15;390(10091):231-66. DOI: https://doi.org/10.1016/S0140-6736(17)30818-8

4. Agustina R, Dartanto T, Sitompul R, et al. Universal health coverage in Indonesia: concept, progress, and challenges. Lancet 2019; 393: 75–102.

5. Soewondo P, Nadjib M, Sari K, et al. National Health Accounts Indonesia Tahun 2020. Jakarta: Lembaga Penerbit BKPK.

6. Dalal K, Aremu O, Ussatayeva G, et al. Out-of-pocket health expenditure and fairness in utilization of health care facilities in Cambodia in 2005 and 2010. F1000Res 2017; 6: 2066.

7. van den Hof S, Collins D, Hafidz F, et al. The socioeconomic impact of multidrug resistant tuberculosis on patients: Results from Ethiopia, Indonesia and Kazakhstan. BMC Infect Dis; 16. Epub ahead of print 2016. DOI: 10.1186/s12879-016-1802-x.

8. Tulenko K, Møgedal S, Afzal MM, et al. Community health workers for universal health-care coverage: from fragmentation to synergy. Bull World Health Organ 2013; 91: 847–852.

9. The Lancet Global Health. Community health workers: emerging from the shadows? Lancet Glob Health 2017; 5: e467.

10. Krejcie RV, Morgan DW. Determining Sample Size for Research Activities. Educ Psychol Meas 1970; 30: 607–610.

11. Wang H, Chen K, Pan Y, et al. Associations and impact factors between living arrangements and functional disability among older Chinese adults. PLoS One 2013; 8: e53879.

12. Alavi K, Sail RM, Idris K, et al. Living arrangement preference and family relationship expectation of elderly parents. Pertanika Journal of Social Science and Humanities 2011; 19: 65–73.

13. Natividad JN, Cruz GT. Patterns in living arrangements and familial support for the elderly in the Philippines. Asia Pac Popul J 1997; 12: 17–34.

14. Magsamen-Conrad K, Dillon JM, Billotte Verhoff C, et al. Online Health-Information Seeking Among Older Populations: Family Influences and the Role of the Medical Professional. Health Commun 2019; 34: 859–871.

15. Medlock S, Eslami S, Askari M, et al. Health Information–Seeking Behavior of Seniors Who Use the Internet: A Survey. J Med Internet Res 2015; 17: e3749.

16. Prince MJ, Wu F, Guo Y, et al. The burden of disease in older people and implications for health policy and practice. Lancet 2015; 385: 549–562.

17. Peltzer K, Phaswana-Mafuya N. Patient experiences and health system responsiveness among older adults in South Africa. Glob Health Action 2012; 5: 1–11.

18. Adhikari D, Rijal DP. Factors affecting the health-seeking behavior of senior citizens of Dharan. J Nobel Med College 2014;3(1):50–7.

19. Sadlowska I, Rees E. Quality of life in the UK: August 2022. Office for National Statistics, https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/bulletins/qualityoflifeintheuk/august2022 (2022, accessed August 4, 2023).

20. Fernández-Niño JA, Manrique-Espinoza BS, Bojorquez-Chapela I, et al. Income inequality, socioeconomic deprivation and depressive symptoms among older adults in Mexico. PLoS One 2014; 9: e108127.

21. Galloway S. Cultural participation and individual quality of life: A review of research findings. Appl Res Qual Life 2007; 1: 323–342.

22. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jr, Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., Jr, Roccella, E. J., National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, & National High Blood Pressure Education Program Coordinating Committee (2003). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 289(19), 2560–2572. https://doi.org/10.1001/jama.289.19.2560

23. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. (2000). World Health Organization technical report series, 894, i–253.



DOI: https://doi.org/10.22146/jcoemph.86497

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