Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy
- Older population OR Elderly OR Ageing population OR Geriatric
- Enabler* OR Enabling OR Factor* OR Facilitator OR Motivator*
- Barrier* OR Limitation* OR Restriction OR Challenges OR Difficulty
- Health Service* OR Health care OR Healthcare
- South-East Asia OR Brunei OR Burma OR Myanmar OR Cambodia OR Timor-Leste OR Indonesia OR Laos OR Malaysia OR Philippines OR Singapore OR Thailand OR Vietnam
- 1 AND 2 AND 3 AND 4 AND 5
2.2. Selection Criteria
2.3. Selection of Included Publications
2.4. Data Extraction and Analysis
- Availability compares the volume and type of available healthcare services with the demand for said services. Availability refers to whether healthcare providers and facilities (including clinics and hospitals), including providers of specialized services such as mental health and emergency care, can adequately supply the said services.
- Accessibility refers to the location of healthcare services and the location of the demand for said services, considering distance, travel cost, and time to travel to these services.
- Accommodation pertains to how healthcare services meet the demand for their services (for example, appointment systems, operation hours, walk-in facilities, telephone services).
- Affordability describes the cost of healthcare services and the availability of insurance and/or other means to pay for said services.
- Acceptability refers to whether the parties demanding healthcare services accept the personal and other characteristics of the healthcare providers (including age, sex, location, type of facility, religious affiliation) and trust the healthcare providers.
3. Results
3.1. Literature Search
3.2. Characteristics of the Included Studies
3.2.1. Availability
3.2.2. Accessibility
3.2.3. Accommodation
3.2.4. Affordability
3.2.5. Acceptability
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Author/Year/Country | Study Design | Objective | Population Age | Service Type | Outcome Types | Findings |
---|---|---|---|---|---|---|
Carandang et al. (2019) [20] Philippines | Qualitative study | To examine the perceptions of unmet needs and to explore the coping mechanisms of senior citizens | 60–85 years | Health care services | Unmet need for health care services | Themes: Staffing problem, drug supply problem and accessibility—health centre is far away from home |
Goh (2011) [21] Singapore | Mixed method study | Understanding the family care of elderly person and their use of post-acute care services | 65 years and over | Post-acute care services (Community hospital, Nursing home, Day Rehabilitation Centre) | Predisposing factor Enabling factor Need factor | Individual variables such as ethnicity, family size, paid help and housing type meditate use and draw attention to underlying financial barriers. |
Horn R et al. (2018) [22] Cambodia | Qualitative study | To explore the oral health experiences, practices and perceptions of older adults in Cambodia. | 60 years and over | Oral health | Social Environment Physical Environment Use of services | Physical environment themes: Problems with transport to health facilities. Use of Service themes: Cost as a main barrier, inconvenient operating hours |
Irwan et al. (2016) [23] Indonesia | Quantitative study | To examine self-care practices and health-seeking behaviours of older adults in urban Indonesia | 60 years and over | Health care services | Predisposing factor Enabling factor Need factor | Respondents with higher self-efficacy, those who did not want to get information, and those of younger ages are less likely to visit health centre regularly |
Kamsan et al. (2021) [24] Malaysia | Quantitative study | To determine the healthcare utilization and its associated factors among older persons with knee OA | 60 years and over | Outpatient, inpatients and pharmacotherapy | Predisposing factor Enabling factor Need factor | Being married and having an income is associated with the usage of outpatient services and pharmacotherapy |
Kanthawee et al. (2014) [25] Thailand | Mixed method study | To describe perception towards health and social services among elderly people in Chiang Rain province | 60 years and over | Health care services | Barriers to access on health services | Cost of transportation and unviability of family members. Difficult to assess hospital because hospital is quite far from their home |
Kullanit and Taneepanichskul (2017) [26] Thailand | Quantitative study | To examine the association between healthcare utilization and transportation barriers and perception among elderly in Thailand | 60 years and over | Health care services (health promoting hospital, district hospital and provincial hospital) | Transportation barrier (travel duration, distance from home, have company, expenses) Accessibility of healthcare facilities on transportation | Travel duration and distance from elderly home to healthcare services was associated with healthcare utilization. Elderly satisfaction and perception on ability to pay for transportation expense was related to their healthcare utilization. |
Lee et al. (2013) [27] Timor-Leste | Quantitative study | To identify and compare the barriers in using eye care services | Adults aged 40 years and above | Eye Care Services | Barrier to use eye care services | Participants aged ≥60 years were more likely to claim they were too old, there was no-one to accompany them or fear as barrier in using eye care services |
Madyaningrum et al. (2018) [28] Indonesia | Quantitative study | To identify factors related to the use of outpatient services among the Indonesian elderly | 60 years and over | Outpatient services | Predisposing factor Enabling factor Need factor | Economic status, health insurance, self-rated health, region and number of chronic conditions were associated with use of outpatient services. |
Meemon and Paek (2020) [29] Thailand | Quantitative study | To explore incidence rate of and reasons for unmet health needs for older adults living alone | 65 years and over | Health care services | Socio-economic characteristics on unmet health needs | For older adults living alone and living with one family member, lack of caretakers and quality of care was one of the major reasons for unmet health needs. Those living with more than one family members reported quality of care in the hospital as reason for unmet health needs. |
Mittal et al. (2019) [30] Singapore | Qualitative study | To understand factors affecting dental care utilisation among older Singaporeans who are eligible for CHAS or PG subsidies | 65 years and over | Dental care | Barriers to visit dental clinic | Fear, anxiety and past negative experience with dentist, do not perceive need to visit dentist and lack of awareness |
Neyhouser et al. (2018) [31] Cambodia | Qualitative study | (i) To identify consumer and provider barriers for women accessing eye health care. (ii) To identify provider barres for wo | 45–84 years (mean age 63) | Eye care | Perceptions regarding access barriers to eye health care | Gender-based differences in decision-making, access and control over resources and women’s social status contribute to impeding women’s access to eye health services |
Quashie and Pothisiri (2018) [32] Thailand | Quantitative study | To explore the rural-urban gaps in health care utilization among older Thais. | 50 years and over | Health care services | Predisposing factor Enabling factor Need factor | Predisposing factors and health needs narrow the rural-urban gap while enabling factors widened the gap in health visits. |
Rittirong J (2019) [33] Thailand | Quantitative study | Factors predicting health centre visits among elderly with chronic illness | 60 years and over | Health care services | Living arrangement Geographic and modes of travel | Elderly living with adult child more likely to visit health care. |
Samsudin and Abdullah (2017) [34] Malaysia | Quantitative study | To identify the determinant of health care utilisation by the elderly in northern states of Malaysia | 60 years and over | Doctor visit and inpatient stays | Predisposing factor Enabling factor Need factor | Only age and use of alternative healthcare have roles in determining likelihood of doctor’s visit. Inpatient determinants; (i) Socio-economic factors (ii) Gender |
Thammatacharee et al. (2012) [35] Thailand | Quantitative study | Assess annual prevalence, characteristics and reasons for unmet healthcare need in the Thai population | 60 years and over | Outpatient and inpatient | Socio-economic characteristics | The most prevalent reasons for unmet outpatient healthcare needs among those aged 60 years and above are (i) too far to travel, (ii) not sure these are effective treatments and (iii) ‘other reasons’. Inpatient unmet reasons: (i) No accompanies, (ii) ‘other reasons’ |
Van et al. (2021) [36] Vietnam | Quantitative study | Prevalence of associated factors among the elderly living in rural Vietnam | 60 years and over | Mental health care services | Socioeconomic information Perceived social support Perceived Barriers to Psychological Treatment (PBPT) | Foremost barriers to psychological service are (i) emotional concerns about psychological services, (ii) geographic and financial difficulties, (iii) participation restrictions |
Nguyen and Giang [37] (2021) Vietnam | Quantitative study | To examine factors affecting the use of healthcare services using Anderson’s Behavioural Model | 60 years and over | Public and private healthcare facilities | Predisposing factor Enabling factor Need factor | Having to pay medical costs was the major reason for older people not using all kinds of healthcare facilities |
Laksono et al. (2018) [38] Indonesia | Quantitative study | To examine the barriers for the elderly in accessing health services | 50 years and above | Health care services | Travel time, transportation cost, insurance ownership | Elderly living both in urban and rural have moderate access barrier to health center. 15% of very poor elderly have major access barrier. |
Publication | Availability | Accessibility | Accommodation | Affordability | Acceptability |
---|---|---|---|---|---|
Carandang et al. (2019) [20] | X | X | |||
Goh (2012) [21] | X | X | |||
Horn R et al. (2017) [22] | X | X | X | ||
Irwan et al. (2016) [23] | X | ||||
Kamsan et al. (2021) [24] | X | X | |||
Kanthawee et al. (2014) [25] | X | ||||
Kullanit at Taneepanichskul (2017) [26] | X | X | |||
Lee et al. (2013) [27] | X | ||||
Madyaningrum et al. (2014) [28] | X | X | |||
Meemon and Paek (2020) [29] | X | X | X | ||
Mittal et al. (2019) [30] | X | X | |||
Neyhouser et al. (2018) [31] | X | ||||
Nguyen and Giang (2021) [32] | X | ||||
Quashie (2018) [33] | X | ||||
Rittirong J (2019) [34] | X | ||||
Samsudin and Abdullah (2017) [35] | X | ||||
Thammatacharee et al. (2012) [36] | X | X | |||
Van et al. (2021) [37] | X | X | X | ||
Laksono et al. (2018) [38] | X | X |
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Mohd Rosnu, N.S.; Singh, D.K.A.; Mat Ludin, A.F.; Ishak, W.S.; Abd Rahman, M.H.; Shahar, S. Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review. Int. J. Environ. Res. Public Health 2022, 19, 7351. https://doi.org/10.3390/ijerph19127351
Mohd Rosnu NS, Singh DKA, Mat Ludin AF, Ishak WS, Abd Rahman MH, Shahar S. Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review. International Journal of Environmental Research and Public Health. 2022; 19(12):7351. https://doi.org/10.3390/ijerph19127351
Chicago/Turabian StyleMohd Rosnu, Nurul Syuhada, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Wan Syafira Ishak, Mohd Harimi Abd Rahman, and Suzana Shahar. 2022. "Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review" International Journal of Environmental Research and Public Health 19, no. 12: 7351. https://doi.org/10.3390/ijerph19127351