The Health-Seeking Behavior of the Elderly with Non-communicable Diseases at Coastal areas, Vietnam

Abstract

Background The aging population is rapidly increasing globally. It proves a severe impact on developing and low-income countries due to insufficient resources and lack of awareness towards the challenges of health issues. In Vietnam, over 11 million people aged 60 and over, accounting for 11.8% of the population. It is projected that by 2050 there will be nearly 29 million people (HelpAge, 2018). People over 60 years old have 2.6 diseases, over 80 years old have 6.8 diseases on average (Dang Thi Thanh et al., 2018; MOH, 2020). Therefore, healthcare facilities and the health services behavior of older populations with non-communicable diseases are considered important in formulating a health program targeting this group. Significantly, the coastal area is a challenging area where participants live (Government, 2016b). Purpose This study aimed to investigate the health-seeking behavior of the elderly with non-communicable diseases, and its associated factors. Method A Cross-sectional study was conducted in seven coastal areas in Thua Thien Hue province, Vietnam, with a sample of 370 people aged 60 years and older. Physicians diagnosed the presence of non-communicable diseases at health care facilities. Information on independent variables such as social, demographic, perceived health status, etc., and dependent variables such as health-seeking behavior through the utilization of healthcare services were collected using a structured questionnaire. In addition, a pilot investigation questionnaire on patients who visit a primary healthcare unit in one of seven coastal areas was conducted, and investigators were trained before collecting data. Chi-square and multiple logistic regression analyses were used to examine the factors associated with the utilization of health care services. Results The mean age of participants was 69.70 ± 6.6 (SD). Over half of the participants were fishery or agriculture, 14.3% of them were under an average standard of economic. The proportion of multiple non-communicable diseases was 18%. The disease duration was mainly about 5-10 years and more than ten years with the rate over 40%, respectively. Most participants were diagnosed at public health facilities. A third of quarter of participants required health care counseling. The results of the study showed that 69.8% of the total participants had health-seeking behavior. The findings also revealed that the elderly living alone were likely to have 4.5 times less health-seeking behavior than those who did not live alone (OR: 4.48, 95% CI: 1.016-19.78, p=0.048). Similarly, the economic status was related to the health-seeking behavior. People with an average and wealthier income seemed to have 2.8 times higher utilization of healthcare services than the poor and below the average group (OR: 2.81, 95% CI: 1.11-7.11, p=0.029). A group with multiple NCDs were more likely to have nine times higher health-seeking behavior than those with only one disease (OR: 9.24, 95% CI: 2.665-32.15, p=<0.001). Health insurance and the needed for health care counseling were also relevant (OR: 4.16, 95% CI: 1.30-13.31, p=0.016), (OR: 3.91, 95% CI: 2.04-7.49, p<0.001), respectively. Conclusion Health-seeking behavior is one of the most important positive implications for the aged population, encompassing one's physical, mental, and psychological wellbeing. The future study would be clarifying the same results in-depth to understand and improve the health-seeking behavior in the elderly and enhance their quality of life.