Journal of Biomedical and Engineering Research

Utilization of Health Services Among Elderly People Enrolled in National Health Insurance Program: A Cross-Sectional Study From Pokhara , Nepal

Abstract

Bipana Tiwari and Hari Prasad Kaphle

Introduction
Ensuring access to healthcare services for the elderly is a global imperative. The growing elderly population leads to a higher demand for healthcare services because of rising instances of chronic illnesses and a generally lower perceived state of health. This study assesses the utilization of health services and its associated factors among the elderly people enrolled in the national health insurance program (NHIP) in Pokhara, Nepal.

Materials and Methods
A community-based cross-sectional study was conducted among 275 insured elderly people of Pokhara Metropolitan using multistage probability sampling. A structured interview schedule was used to collect the data. Data were entered in Epi-data and analyzed using the Statistical Package for Social Sciences (SPSS). Uni-variate, bi-variate and multivariate analyses were carried out to obtain results as per our objectives.

Results
The result of the study shows that among 275 participants, more than half of them (51.6%) utilized health services under the national health insurance program in the last 12 months. Moreover, elderly people who were aware of national health insurance were two and a half times (AOR = 2.53; 95% CI: 1.32-4.86) more likely to utilize health services. Similarly, participants who had experienced some type of illness within the last 12 months were about eleven times (AOR = 11.35;
95% CI: 3.51-36.66) and participants with chronic diseases were about two times (AOR 2.10; 95% CI: 1.04-4.24) more likely to utilize health services under the national health insurance program. Factors that determine the non-utilization of NHI services were not being ill, seeking other services, required services not included in the scheme, hearing bad news about service delivery, long waiting lines in the health facility and bothersome procedure to get treatment.

Conclusion
A significant proportion of the elderly did not use the health services though enrolled in national health insurance. It is recommended to conduct different awareness activities among this segment of the society. Moreover, immediate attention is needed to expand the package to cover most of the health needs of the elderly population and to modify in service delivery mechanism.

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