Utilization of healthcare facilities and associated factors among rural elderly in Kanyakumari District, Tamil Nadu

Background: Rapidly progressing population ageing in India translates into more chronic diseases and healthcare expenditure among the elderly. But inadequate geriatric centred services in rural areas may hinder the health seeking behaviour among rural elderly. Hence, this study was done to assess utilization of healthcare facilities by elderly in rural Kanyakumari and to identify factors associated with it. Methods: Elderly people above 60 years of age were selected from rural Kanyakumari by multistage sampling. 250 subjects for the cross-sectional study were finalised after excluding debilitated elderly. Data was collected by a pretested questionnaire after getting informed consent. Results: Mean age of the study group was 70.12 years. 60% of elderly were currently married while 70.8% elderly were unemployed. More than half of the elderly population (57.6%) claimed to avoid healthcare facilities in times of need, citing cost of hospital care (27.6%) and perceived triviality of illness as the most common reasons. More than 75% elderly used out of pocket expenditure to meet healthcare expenses. Most of them (96%) did not have health insurance. Elderly people with education beyond primary school level and belonging to upper socioeconomic status had a statistically significant association with better healthcare utilization. Conclusion: Perception of disease as an age-related phenomenon has to be negated in order to improve healthcare utilization. Also, the importance of healthcare in improving functionality has to be conveyed to the community. Affordable and universal healthcare suited to geriatric needs have to be made available to the rural elderly population.