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Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review

Gao, Qian; Prina, A Matthew; Ma, Yuteng; Aceituno, David; Mayston, Rosie; (2022) Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review. International Journal of Health Services , 52 (1) pp. 99-114. 10.1177/00207314211041234. Green open access

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Abstract

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Six databases were searched, including Embase, Medline, Psych Info, Global Health, Latin American and Caribbean Health Sciences Literature (LILACS), and China National Knowledge Infrastructure, CNKI, to identify eligible studies. A narrative synthesis approach was used for evidence synthesis. A total of 20 eligible cross-sectional studies were included in this systematic review. The indicators of socioeconomic status (SES) identified included income level, education, employment/occupation, and health insurance. Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs, with results varying by indicators of SES and study settings.

Type: Article
Title: Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/00207314211041234
Publisher version: https://doi.org/10.1177/00207314211041234
Language: English
Additional information: © The Author 2022. Original content in this paper is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/).
Keywords: health care utilization, primary health care, socioeconomic status, low- and middle- income countries, aging
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10156059
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