Predictors of health care use by adults 50 years and over in a rural South African setting.
Identifieur interne : 000B56 ( Ncbi/Merge ); précédent : 000B55; suivant : 000B57Predictors of health care use by adults 50 years and over in a rural South African setting.
Auteurs : Soter Ameh [Afrique du Sud] ; Francesc Xavier G Mez-Olivé [Afrique du Sud] ; Kathleen Kahn [Afrique du Sud] ; Stephen M. Tollman [Afrique du Sud] ; Kerstin Klipstein-Grobusch [Afrique du Sud]Source :
- Global health action [ 1654-9880 ] ; 2014.
Abstract
Background South Africa's epidemiological transition is characterised by an increasing burden of chronic communicable and non-communicable diseases. However, little is known about predictors of health care use (HCU) for the prevention and control of chronic diseases among older adults. Objective To describe reported health problems and determine predictors of HCU by adults aged 50+ living in a rural sub-district of South Africa. Design A cross-sectional study to measure HCU was conducted in 2010 in the Agincourt sub-district of Mpumalanga Province, an area underpinned by a robust health and demographic surveillance system. HCU, socio-demographic variables, reception of social grants, and type of medical aid were measured, and compared between responders who used health care services with those who did not. Predictors of HCU were determined by binary logistic regression adjusted for socio-demographic variables. Results Seventy-five percent of the eligible adults aged 50+ responded to the survey. Average age of the targeted 7,870 older adults was 66 years (95% CI: 65.3, 65.8), and there were more women than men (70% vs. 30%, p<0.001). All 5,795 responders reported health problems, of which 96% used health care, predominantly at public health facilities (82%). Reported health problems were: chronic non-communicable diseases (41% - e.g. hypertension), acute conditions (27% - e.g. flu and fever), other conditions (26% - e.g. musculoskeletal pain), chronic communicable diseases (3% - e.g. HIV and TB), and injuries (3%). In multivariate logistic regression, responders with chronic communicable disease (OR=5.91, 95% CI: 1.44, 24.32) and non-communicable disease (OR=2.85, 95% CI: 1.96, 4.14) had significantly higher odds of using health care compared with those with acute conditions. Responders with six or more years of education had a two-fold increased odds of using health care (OR=2.49, 95% CI: 1.27, 4.86) compared with those with no formal education. Conclusion Chronic communicable and non-communicable diseases were the most prevalent and main predictors of HCU in this population, suggesting prioritisation of public health care services for chronic diseases among older people in this rural setting.
DOI: 10.3402/gha.v7.24771
PubMed: 28672602
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Tollman</name><affiliation wicri:level="1"><nlm:affiliation>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg </wicri:regionArea><wicri:noRegion>Johannesburg </wicri:noRegion></affiliation></author><author><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><affiliation wicri:level="1"><nlm:affiliation>e Division of Epidemiology and Biostatistics School of Public Health, University of the Witwatersrand , Johannesburg , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>e Division of Epidemiology and Biostatistics School of Public Health, University of the Witwatersrand , Johannesburg </wicri:regionArea><wicri:noRegion>Johannesburg </wicri:noRegion></affiliation></author></analytic><series><title level="j">Global health action</title><idno type="eISSN">1654-9880</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background South Africa's epidemiological transition is characterised by an increasing burden of chronic communicable and non-communicable diseases. However, little is known about predictors of health care use (HCU) for the prevention and control of chronic diseases among older adults. Objective To describe reported health problems and determine predictors of HCU by adults aged 50+ living in a rural sub-district of South Africa. Design A cross-sectional study to measure HCU was conducted in 2010 in the Agincourt sub-district of Mpumalanga Province, an area underpinned by a robust health and demographic surveillance system. HCU, socio-demographic variables, reception of social grants, and type of medical aid were measured, and compared between responders who used health care services with those who did not. Predictors of HCU were determined by binary logistic regression adjusted for socio-demographic variables. Results Seventy-five percent of the eligible adults aged 50+ responded to the survey. Average age of the targeted 7,870 older adults was 66 years (95% CI: 65.3, 65.8), and there were more women than men (70% vs. 30%, p<0.001). All 5,795 responders reported health problems, of which 96% used health care, predominantly at public health facilities (82%). Reported health problems were: chronic non-communicable diseases (41% - e.g. hypertension), acute conditions (27% - e.g. flu and fever), other conditions (26% - e.g. musculoskeletal pain), chronic communicable diseases (3% - e.g. HIV and TB), and injuries (3%). In multivariate logistic regression, responders with chronic communicable disease (OR=5.91, 95% CI: 1.44, 24.32) and non-communicable disease (OR=2.85, 95% CI: 1.96, 4.14) had significantly higher odds of using health care compared with those with acute conditions. Responders with six or more years of education had a two-fold increased odds of using health care (OR=2.49, 95% CI: 1.27, 4.86) compared with those with no formal education. Conclusion Chronic communicable and non-communicable diseases were the most prevalent and main predictors of HCU in this population, suggesting prioritisation of public health care services for chronic diseases among older people in this rural setting.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">28672602</PMID><DateCreated><Year>2017</Year><Month>07</Month><Day>04</Day></DateCreated><DateRevised><Year>2017</Year><Month>07</Month><Day>04</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1654-9880</ISSN><JournalIssue CitedMedium="Internet"><Volume>7</Volume><Issue>1</Issue><PubDate><Year>2014</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Global health action</Title><ISOAbbreviation>Glob Health Action</ISOAbbreviation></Journal><ArticleTitle>Predictors of health care use by adults 50 years and over in a rural South African setting.</ArticleTitle><Pagination><MedlinePgn>24771</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3402/gha.v7.24771</ELocationID><Abstract><AbstractText>Background South Africa's epidemiological transition is characterised by an increasing burden of chronic communicable and non-communicable diseases. However, little is known about predictors of health care use (HCU) for the prevention and control of chronic diseases among older adults. Objective To describe reported health problems and determine predictors of HCU by adults aged 50+ living in a rural sub-district of South Africa. Design A cross-sectional study to measure HCU was conducted in 2010 in the Agincourt sub-district of Mpumalanga Province, an area underpinned by a robust health and demographic surveillance system. HCU, socio-demographic variables, reception of social grants, and type of medical aid were measured, and compared between responders who used health care services with those who did not. Predictors of HCU were determined by binary logistic regression adjusted for socio-demographic variables. Results Seventy-five percent of the eligible adults aged 50+ responded to the survey. Average age of the targeted 7,870 older adults was 66 years (95% CI: 65.3, 65.8), and there were more women than men (70% vs. 30%, p<0.001). All 5,795 responders reported health problems, of which 96% used health care, predominantly at public health facilities (82%). Reported health problems were: chronic non-communicable diseases (41% - e.g. hypertension), acute conditions (27% - e.g. flu and fever), other conditions (26% - e.g. musculoskeletal pain), chronic communicable diseases (3% - e.g. HIV and TB), and injuries (3%). In multivariate logistic regression, responders with chronic communicable disease (OR=5.91, 95% CI: 1.44, 24.32) and non-communicable disease (OR=2.85, 95% CI: 1.96, 4.14) had significantly higher odds of using health care compared with those with acute conditions. Responders with six or more years of education had a two-fold increased odds of using health care (OR=2.49, 95% CI: 1.27, 4.86) compared with those with no formal education. Conclusion Chronic communicable and non-communicable diseases were the most prevalent and main predictors of HCU in this population, suggesting prioritisation of public health care services for chronic diseases among older people in this rural setting.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ameh</LastName><ForeName>Soter</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>b Community Medicine Department College of Medical Sciences, University of Calabar , Cross River State , Nigeria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Olivé</LastName><ForeName>Francesc Xavier</ForeName><Initials>FX</Initials><AffiliationInfo><Affiliation>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>c INDEPTH Network Accra , Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kahn</LastName><ForeName>Kathleen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>c INDEPTH Network Accra , Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>d Umeå Centre for Global Health Research, Epidemiology and Global Health , Umeå University , Umeå , Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tollman</LastName><ForeName>Stephen M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>a MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>c INDEPTH Network Accra , Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>d Umeå Centre for Global Health Research, Epidemiology and Global Health , Umeå University , Umeå , Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klipstein-Grobusch</LastName><ForeName>Kerstin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>e Division of Epidemiology and Biostatistics School of Public Health, University of the Witwatersrand , Johannesburg , South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>f Julius Global Health Julius Centre for Health Sciences and Primary Care , University Medical Centre Utrecht , Utrecht , The Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Glob Health Action</MedlineTA><NlmUniqueID>101496665</NlmUniqueID><ISSNLinking>1654-9880</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Agincourt</Keyword><Keyword MajorTopicYN="N">South Africa</Keyword><Keyword MajorTopicYN="N">chronic diseases</Keyword><Keyword MajorTopicYN="N">health care use</Keyword><Keyword MajorTopicYN="N">older adults</Keyword><Keyword MajorTopicYN="N">predictors</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>7</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>12</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>12</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28672602</ArticleId><ArticleId IdType="doi">10.3402/gha.v7.24771</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Afrique du Sud</li></country></list><tree><country name="Afrique du Sud"><noRegion><name sortKey="Ameh, Soter" sort="Ameh, Soter" uniqKey="Ameh S" first="Soter" last="Ameh">Soter Ameh</name></noRegion><name sortKey="G Mez Olive, Francesc Xavier" sort="G Mez Olive, Francesc Xavier" uniqKey="G Mez Olive F" first="Francesc Xavier" last="G Mez-Olivé">Francesc Xavier G Mez-Olivé</name><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><name sortKey="Tollman, Stephen M" sort="Tollman, Stephen M" uniqKey="Tollman S" first="Stephen M" last="Tollman">Stephen M. 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