scholarly journals Differentials and predictors of hospitalization among the elderly people in India: Evidence from 75th round of National Sample Survey (2017-18)

Author(s):  
Saddaf Naaz Akhtar ◽  
Nandita Saikia

AbstractIntroductionThere are limited evidences on the determinants of hospitalization and its causes in India. We examined the differential in the hospitalization rates and its socio-economic determinants. We also examined the causes of diseases in hospitalization among the elderly (≥60 years) in India.MethodsWe used data from 75th round of the National Sample Survey Organizations (NSSO), collected from July 2017 to June 2018. The elderly samples in this survey are 42759, where 11070 were hospitalized, and 31,689 were not hospitalized in the last year or 365 days. We estimated hospitalization rates and carried out binary logistic regression analysis to examine the associations of hospitalization with the background variables. The cause of diseases in hospitalizations were also calculated.ResultsHospitalization rate was lower among female elderly compared to male elderly. Elderly who belongs to middle-old aged groups, non-married, North-Eastern region, Southern region, general caste, health insurance, partially & fully economically dependent elderly have a higher chance of being hospitalized. About 38% elderly were hospitalized due to communicable diseases (CDs), 52% due to non-communicable diseases (NCDs) and 10% due to Injuries & others. Nearly 40% elderly were hospitalized in public hospitals due to CDs, while 52% were hospitalized in private hospitals due to NCDs and 11% due to Injuries & others.ConclusionsRaising awareness, promoting a healthy lifestyle, and improving the quality of good healthcare provisions at the primary level is necessary. Early screening and early treatment for NCDs are needed, which is non-existent in almost all parts of India.

Author(s):  
Alok Ranjan ◽  
Muraleedharan V R

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability.Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation.Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly has health insurance though chances of facing catastrophic health expenditure was high in the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of elderly of age 80 years or above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles.Conclusions: The vulnerability of India’s elderly increases across various equity dimensions which include the place of residence, gender, caste, marital status, economic quintile, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may lead to detrimental health impact.Trial Registration: No applicable since the study is based on secondary data.


2020 ◽  
Author(s):  
Alok Ranjan ◽  
Muraleedharan V R

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate among the elderly population. Aim of the study is to highlight the vulnerability of the aged amidst the current COVID-19 pandemic, and in the light of the recent international evidence, suggests what government could do to mitigate their vulnerability. Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation. Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Among the elderly, hospitalization rate was higher in the urban areas (OR: 1.23), general social category (OR: 1.18), richest economic quintile (OR: 1.69), and among those living alone (OR: 2.40). Also, among the elderly, 64% of those in the scheduled tribe (social class) and 51.0% in the poorest income quintile utilized public facilities for hospitalization. “Cardiovascular ailments” was a major cause for hospitalization (18.1%) and outpatient visit (32.0%) among the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly had health insurance though chances of facing catastrophic health expenditure was high among the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of age 80 years and above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions: The vulnerability of India’s elderly increases across economic levels, and other dimensions such as the place of residence, gender, caste, marital status, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may cause detrimental health impact.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Alok Ranjan ◽  
V. R. Muraleedharan

Abstract Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate among the elderly population. Aim of the study is to highlight the vulnerability of the aged amidst the current COVID-19 pandemic, and in the light of the recent international evidence, suggests what government could do to mitigate their vulnerability. Methods Data from the recently released (November 2019) 75th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555,115 individuals (rural: 325,232; urban: 229,232) included 42,762 elderly individuals (60 years or above). Bivariate and multivariate analyses were used for the calculation. Results Of the total sample of elderly individuals, 27.7% reported suffering from an ailment in the last 15 days, whereas 8.5% had been hospitalized during the last 365 days. Among the elderly, hospitalization rate was higher in the urban areas (OR: 1.23), general social category (OR: 1.18), richest economic quintile (OR: 1.69), and among those living alone (OR: 2.40). Also, among the elderly, 64% of those in the scheduled tribe (social group) and 51% in the poorest economic quintile utilized public facilities for hospitalization. Cardiovascular ailments were the major cause for hospitalization (18.1%) and outpatient visit (32%) among the elderly. Ailments related to diabetes and hypertension constituted 55% of outpatient visit for the elderly. Only 18.9% of the elderly had health insurance though chances of facing catastrophic health expenditures were high among the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of age 80 years and above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions The vulnerability of India’s elderly increases across economic levels, and other dimensions such as the place of residence, gender, social group (caste), marital status, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may cause detrimental health impact. Trial registration Not applicable since the study is based on secondary data.


2010 ◽  
Vol 43 (2) ◽  
pp. 211-231 ◽  
Author(s):  
ZAKIR HUSAIN ◽  
SASWATA GHOSH

SummaryThe increasing greying of India's population raises concerns about the welfare and health status of the aged. One important source of information of health status of the elderly is the National Sample Survey Rounds on Morbidity and Health Care Expenditure. Using unit-level data for 1995–96 and 2004, this paper examines changes in reported health status of the elderly in India and analyses their relationship with living arrangements and extent of economic dependency. It appears that even after controlling for factors like caste, education, age, economic status and place of residence, there has been a deterioration in self-perceived current health status of the elderly. The paper argues that, although there have been changes in the economic condition and traditional living arrangements – with a decline in co-residential arrangements – this is not enough to explain the decline in reported health status and calls for a closer look at narratives of neglect being voiced in developing countries.


2020 ◽  
Author(s):  
Alok Ranjan ◽  
Muraleedharan V R

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability. Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation. Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly has health insurance though chances of facing catastrophic health expenditure was high in the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of elderly of age 80 years or above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions: The vulnerability of India’s elderly increases across various equity dimensions which include the place of residence, gender, caste, marital status, economic quintile, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may lead to detrimental health impact.


2015 ◽  
Vol 48 (4) ◽  
pp. 472-485 ◽  
Author(s):  
Ajit Kumar Yadav ◽  
Jitendra Gouda ◽  
F. Ram

SummaryUttar Pradesh is India’s most populous state with a population of 200 million. Any change in its fertility and mortality is bound to bring change at the national level. This study analysed the burden of disease in the state by calculating the disability-adjusted life year (DALY) for infectious and non-communicable diseases. Data were from two rounds (52ndand 60th) of the National Sample Survey Organization (NSSO) survey conducted in 1995–96 and 2004, respectively, and the Million Deaths Study (MDS) of 2001–03. Descriptive and multivariate analyses were carried out to identify the determinants of different types of self-reported morbidity and DALY. The results show that in Uttar Pradesh the prevalence of all selected self-reported infectious and non-communicable diseases increased over the study period from 1995 to 2004, and in most cases by more than two times. The highest observed increase in prevalence was in non-communicable diseases excluding CVDs, which increased from 7% in 1995 to 19% in 2004. The prevalence was higher for those aged 60 and above, females, those who were illiterate and rich across the time period and for all selected morbidities. The results were significant atp<0.001. The estimation of the DALY revealed that the burden of infectious diseases was higher during infancy, noticeably among males than females in 2002. However, females aged 1–5 years were more likely to report infectious diseases than corresponding males. The age distribution of the DALY indicated that individuals aged below 5 years and above 60 years were more susceptible to ill health. The growing incidence of non-communicable diseases, especially among the older generation, puts an additional burden on the health system in the state. Uttar Pradesh has to grapple with the unresolved problem of preventable infectious diseases on the one hand and the growth in non-communicable disease on the other.


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