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dc.contributor.authorZhou, Chengchao
dc.contributor.authorJi, Chunmei
dc.contributor.authorChu, Jie
dc.contributor.authorMedina, Alexis
dc.contributor.authorLi, Cuicui
dc.contributor.authorJiang, Shan
dc.contributor.authorZheng, Wengui
dc.contributor.authorLiu, Jing
dc.contributor.authorRozelle, Scott
dc.date.accessioned2015-09-01T17:01:26Z
dc.date.available2015-09-01T17:01:26Z
dc.date.issued2015-07-29
dc.identifier.citationBMC Health Services Research. 2015 Jul 29;15(1):294
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-015-0974-1
dc.identifier.urihttp://hdl.handle.net/10724/31708
dc.description.abstractAbstract Background Empty-nest elderly refers to those elderly with no children or whose children have already left home. Few studies have focused on healthcare service use among empty-nest seniors, and no studies have identified the prevalence and profiles of non-use of healthcare services among empty-nest elderly. The purpose of this study is to compare the prevalence of non-use of healthcare services between empty-nest and non-empty-nest elderly and identify risk factors for the non-use of healthcare services among empty-nest seniors. Methods Four thousand four hundred sixty nine seniors (60 years and above) were draw from a cross-sectional study conducted in three urban districts and three rural counties of Shandong Province in China. Non-visiting within the past 2 weeks and non-hospitalization in previous year are used to measure non-use of healthcare services. Chi-square test is used to compare the prevalence of non-use between empty-nesters and non-empty-nesters. Multivariate logistic regression analysis is employed to identify the risk factors of non-use among empty-nest seniors. Results Of 4469 respondents, 2667(59.7 %) are empty-nesters. Overall, 35.5 % of the participants had non-visiting and 34.5 % had non-hospitalization. Non-visiting rate among empty-nest elderly (37.7 %) is significantly higher than that among non-empty-nest ones (32.7 %) (P = 0.008). Non-hospitalization rate among empty-nesters (36.1 %) is slightly higher than that among non-empty-nesters (31.6 %) (P = 0.166). Financial difficulty is the leading cause for both non-visiting and non-hospitalization of the participants, and it exerts a larger negative effect on access to healthcare for empty-nest elderly than non-empty-nest ones. Both non-visiting and non-hospitalization among empty-nest seniors are independently associated with low-income households, health insurance status and non-communicable chronic diseases. The non-visiting rate is also found to be higher among the empty-nesters with lower education and those from rural areas. Conclusions Our findings indicate that empty-nest seniors have higher non-use rate of healthcare services than non-empty-nest ones. Financial difficulty is the leading cause of non-use of health services. Healthcare policies should be developed or modified to make them more pro-poor and also pro-empty-nested.
dc.titleNon-use of health care service among empty-nest elderly in Shandong, China: a cross-sectional study
dc.typeJournal Article
dc.date.updated2015-07-29T18:14:57Z
dc.language.rfc3066en
dc.rights.holderZhou et al.


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