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    Predictors of Public and Private Healthcare Utilization and Associated Health System Responsiveness among Older Adults in Ghana

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    Research article (1.384Mb)
    Publication Date
    2017-06-04
    Authors
    Awoke, Mamaru Ayenew
    Negin, Joel
    Moller, Jette
    Farell, Penny
    Yawson, Alfred E.
    Biritwum, Richard Berko
    Kowal, Paul
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    (7 total)
    Type
    Article, Journal
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    Citation

    Mamaru Ayenew Awoke, Joel Negin, Jette Moller, Penny Farell, Alfred E. Yawson, Richard Berko Biritwum & Paul Kowal (2017) Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana, Global Health Action, 10:1, 1301723, DOI: 10.1080/16549716.2017.1301723

    Abstract/Overview

    Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding inter view, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use.

    Subject/Keywords
    Healthcare utilization; Health system responsiveness; Older adults; WHO-SAGE; Ghana
    Further Details

    © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Publisher
    Taylor & Francis
    ISSN
    1654-9716 (Print); 1654-9880 (Online)
    Permalink
    https://repository.amref.ac.ke/handle/123456789/802
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    • General - GEN [355]

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