Academic journal article Central European Journal of Public Health

Accessibility and Use of Health Services among Older Estonian Population

Academic journal article Central European Journal of Public Health

Accessibility and Use of Health Services among Older Estonian Population

Article excerpt

SUMMARY

The aim of the study was to analyse the self-reported use of health services among the older Estonian population, to explain the predictors of health care utilisation and to study access to health services in comparison with other population groups. In November 2005, a randomly sampled Estonian residents aged 15-64 (n=1264) and 65-74 (n=182) was personally interviewed using structured questionnaires. Of the respondents aged 65-74, 81% reported having visited a general practitioner (GP) or specialist during the previous 12 months. Compared to younger people they used health services more often, except dental care. No significant differences were found in comparison with the waiting times to see the general practitioner or specialist between the younger and older population groups. Compared to the rest of the population people aged 65-74 were more satisfied with their access to health services. The probability of visiting a GP was higher for those respondents who had health problems and lived in rural areas. The presence of chronic illness also had an effect on the use of specialist services and ambulance services. Higher education, living in an urban area and having a family member with a chronic illness predicted the use of ambulance services as well. Younger age, higher income and higher education were predictors of the use of dental services. The availability of and access to health services for older people in Estonia are comparable with other groups of the population.

Key words: elderly, health services, utilisation, access

INTRODUCTION

A common trend for most European countries is that their populations are aging. In Estonia the proportion of people aged 65+ has increased from 11.6% in 1990 to 16.3% in 2005 (1). Elderly people are considered one particular group of the population which needs and uses many health services of a various nature and the use of services has been found to increase with age (2-4). Self-rated health status and presence of illness are common factors which predict more frequent use of health services (5, 6). The results of previous studies conducted in Estonia demonstrated a negative correlation between age and self-reported health status, high prevalence of various chronic diseases as well as higher use of primary health care (PHC) services among the older population (7-9). Also, people above 65 years have higher health care expenditures due to paying for medicines out of their own pockets (10).

In Estonia, satisfaction with health services and doctors has been rather high; access to health services has been rather good as well (7, 9, 11-13). Still, people with chronic diseases who were found to be more frequent users of health services were found to be less satisfied with access to health services (13). Like people with chronic diseases older people could be considered as a special group due to their increased need for health services. However, according to a recent report, the health services provided may not be responsive to the older population's needs because of geographical, financial or information barriers, especially in rural areas (14). It has been found that elderly patients may fail to gain access to medication due to having to pay for part of it as well (15).

The aim of this study was to analyse the self-reported use of health services among the older Estonian population and to explain the predictors of health care utilisation. Additionally, access to health services was studied in comparison with other population groups.

MATERIAL AND METHODS

Design

The data were obtained from the survey conducted in November 2005. A random sample of Estonian residents aged 1 5-74 were personally interviewed using structured questionnaires (n=1446). The sample of the study was formed by self-assessment: a proportional model of the total population aged 15-74 was used, where all the respondents represented equally sized groups. …

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