ORCID Profile
0000-0002-2662-2006
Current Organisation
University of Miami
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Publisher: SAGE Publications
Date: 11-01-2021
Abstract: This study aims to evaluate factors associated with health care utilization (HCU) and to assess vertical and horizontal equity in utilization among Nepali older adults. Data are from an existing cross-sectional study involving systematic random s ling of 260 older adults in Far-Western (Sudurpaschim) Province of Nepal. Andersen’s theoretical framework was used to assess predisposing, enabling, and need factors that have the potential to influence health care utilization. Multivariable logistic regression analyses were conducted to examine potential correlates of HCU. Horizontal and vertical equity were assessed using concentration curve and index. More than one-third of participants had not visited a health facility in the prior 12 months. Nine in 10 participants did not know about the government’s free health service for older adults. Joint/extended family type, Ayurvedic/Homeopathic health care preference, higher-income tertile, and presence of chronic conditions were associated with higher odds of health care utilization in adjusted analyses. The concentration curve for HCU lies below the line of equity, and the subsequent index is positive, indicating that HCU was concentrated among richer in iduals. If the government of Nepal is to achieve its goal of universal health care, the existing pro-rich inequity in HCU needs to be addressed.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2019
Publisher: Springer Science and Business Media LLC
Date: 2018
Publisher: Informa UK Limited
Date: 06-2019
DOI: 10.2147/IPRP.S203240
Publisher: Springer Science and Business Media LLC
Date: 02-05-2019
Publisher: MedCrave Group, LLC
Date: 08-02-2017
Publisher: Elsevier BV
Date: 04-2019
Publisher: Springer Science and Business Media LLC
Date: 18-01-2019
DOI: 10.1038/S41371-019-0165-3
Abstract: With an aim to examine the socio-economic inequalities in prevalence, awareness, treatment, and control of hypertension, this study analyzed 14,823 adults, 15 years or older with blood pressure measured, in the 2016 Nepal Demographic Health Survey. Multi-variable logistic regression and Lorenz curves were used to explore the inequalities. The prevalence of hypertension was 19.5% (95% CI: 18.3-20.7). Further, of the total hypertensive, the prevalence of hypertension awareness, treatment and control was 40.0% (95% CI: 37.5-42.6), 20.2% (95% CI: 18.0-22.2) and 10.5% (95% CI: 8.8-12.2), respectively. Participants with secondary (OR: 1.45, 95% CI: 1.20-1.76) and higher education (OR:1.42, 95% CI: 1.10-1.83), compared to those with no education reschool, and those in urban residency (OR: 1.28, 95% CI: 1.09-1.50) compared to rural areas, and in province-4 (OR: 1.50, 95% CI: 1.14-1.96) and province-5 (OR: 1.34, 95% CI: 1.04-1.72), compared to province-1, had higher odds of being hypertensive. Household wealth status showed a positive association with prevalence, awareness, and treatment of hypertension (p-trend < 0.001). Those from richest category were 1.7 times more likely to be hypertensive, were more aware of hypertension (3.2 times), received treatment (5.1 times), and had controlled hypertension (1.6 times), compared to the poorest category. Adjusting for body mass index, completely ameliorate the effect on hypertension prevalence (p-trend = 0.57) and altered nominally awareness (p-trend < 0.0001), treatment (p-trend < 0.0001), and control (p-trend = 0.099). Urban hypertensive females, at the lowest wealth quintile, received poor care services only 12% were aware of their hypertension status, 7% received treatment, and only 4% had controlled hypertension. These socio-economic inequalities warrant interventions aiming at preventing hypertension and increasing coverage of services for those higher at risk. Future studies need to explore socio-economic and geographic disparities in disease burden and cascade of services.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Saruna Ghimire.