NEW DELHI: An elderly person in India must commute up to 15 km to avail out-patient services, and almost 44 km for in-patient care requiring hospitalisation, claims a new study published in The Lancet Regional Health– Southeast Asia.
Researchers analysed data of nearly 32,000 older adults, aged 60 and above, collected during the first wave of the Longitudinal Ageing Study of India (LASI) in 2017-2018 and found there was a significant urban-rural disparity also with the urban older adults availing out-patient facilities within 10 km of reach, while the distance was nearly 30 km for their rural counterparts.
According to the Lancet study, rates of availing both out-patient and in-patient services were found to be high — 73% and 40%, respectively — when a facility was within 10 km of reach. However, with an increase in commute distance, a commensurate decline in the use of out-patient services was found — 17% utilisation of facilities for 11-30 km distance, and 10% for 30 km and above, respectively, it adds.
A longer commute and far-away facility is a barrier for receiving timely, essential healthcare for people in this age group, often seen grappling with multiple long-term, debilitating conditions requiring continuous care, the research team said.
They wrote, “Older adults, on an average, travelled a distance of nine miles (14.5 kilometres) to seek outpatient services and 27 miles (43.6 kilometres) for inpatient care respectively.”
State-wise, Tripura, Manipur and Kerala, had the highest in-patient and outpatient visits within 10 km — over 80%, 75% and 59% of older adults availed in-patient services, respectively, while 88%, 78% and 84% availed out-patient ones, respectively.
The authors attributed Kerala’s high rates to “easy access and better availability of infrastructure”. In Manipur and Tripura, it may be because people rely on nearby facilities during emergency in-patient situations, they said. Hilly states such as Nagaland, Sikkim and Himachal Pradesh could pose geographical challenges as 0%, 17% and about 5%of older adults in these areas made in-patient visits within 10 km, the study found. Further, in northeastern states, such as Mizoram and Nagaland, a higher percentage of older adults were found to travel more than 60 km to access in-patient and out-patient services, indicating a poor and limited access to nearby facilities.
Uttar Pradesh, Bihar, and Madhya Pradesh showed a moderate proximity of 11-60 km for older adults accessing out-patient care, but a higher share of in-patient visits at distances beyond 30 km.
