Publication:

Exploring reasons for non-utilization of healthcare services among older adults with non-communicable diseases in India: evidence from a nationally representative study

Background Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality among Indian older adults, accounting for over two-thirds of the national disease burden. Despite increased access to healthcare, disparities in utilization and treatment-seeking behaviour remain. This study explores the reasons for non-utilization of healthcare services among older adults with NCDs.

Methods This study used 2,598 samples aged 60 and above who reported major reasons for not-visiting healthcare facilities despite their disease diagnosis, from the Longitudinal Ageing Study in India (LASI) wave-1, a nationally representative dataset. The self-reported reasons for non-utilization of healthcare services were used as the dependent variable. Bivariate analysis and multinomial logistic regression were employed to examine the association between non-utilization of healthcare service and NCDs, while socio-demographic and economic characteristics were used as covariates in the analysis.

Results The most cited reasons for not seeking care were illness not serious (41.3%), followed by having medicine at home (32.3%), and financial and work constraints (13.7). Regression results revealed that the elderly with cancer (RRR 47.54), stroke (RRR 8.28), arthritis (RRR 3.46), and lung disease (RRR 2.37) were more likely to report low treatment effectiveness, while psychological issues were more frequently reported reasons due to financial/work constraints (RRR 3.03), and family/other constraints (RRR 4.29) significantly.

Conclusions The findings highlight the reliance on private facilities and the non-utilization of disease-specific healthcare among the elderly. Policies should prioritize financial protection, decentralized chronic care, and interventions to address socioeconomic inequalities, thereby advancing health coverage for India’s ageing population.