Correlates of Healthcare Utilization and Unmet Need for Healthcare Services Among Older Filipinos

by Mark Ryan B. Paguirigan (2023)


The present study examines the healthcare utilization, namely inpatient care, outpatient care, as well as the unmet need for healthcare services, among older Filipinos aged 60 years and over using the Andersen behavioral model for healthcare use as the theoretical model. Data for the analysis was drawn from the baseline data of the Longitudinal Study of Ageing and Health in the Philippines.

Results show that about 15% of older people used inpatient care, while the corresponding figure for those who used outpatient care was 42%. Meanwhile, there is evidence of a high level of unmet need for healthcare services, as indicated by the high proportion of older people who said that they failed to see a doctor even when they felt ill enough to want to see one (29%), for reasons such as financial constraints, self-medication, or physical distance. Employing binomial logistic regression, findings indicate that need factors are the most consistent and important correlates of inpatient utilization, outpatient utilization, and unmet healthcare service needs. Having at least one chronic disease is consistently found to have a significant association with these three healthcare utilization outcomes, whereas those who were severely limited and limited but not severely in the last six months because of a health problem in activities they usually do (GALI) is associated with inpatient care and unmet need for health services, but not with outpatient care. Furthermore, it is found that predisposing and enabling factors played a very minimal role in older people's inpatient and outpatient utilization. However, the urban-rural disparity was prominent for these two healthcare outcomes. Moreover, results show that those in the terminal age group (80+), least educated, belonging to the lowest household quintile, and having at least one IADL difficulty are more likely to report unmet need for healthcare services.

Results have important policy implications for the Philippines as the shift in the demographic makeup, such as the consistent increase in the number and proportion of older Filipinos over time and the growth rate of this subpopulation, suggest an increase in the use of healthcare services in the future.