Decoupling of Elderly Healthcare Demand and Expenditure in China

This study examined the changing trajectory and factors that influenced the health and medical expenditure of the Chinese elderly population over the past two decades. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, inferential and multiple linear regression models were constructed. The key finding is that China has experienced a decoupling of healthcare demand (HCD) and healthcare expenditure (HCE) since around 2014, when HCE began to decline despite the fact that HCD continued to rise. This is a promising sign, suggesting that the government’s health insurance policy is working. Furthermore, participating in health insurance schemes can significantly reduce the elderly’s HCD and HCE, demonstrating that health insurance can effectively affect the elderly’s decision to seek medical treatment and improve their health condition. We also found that age, region, basic old-age insurance, and care by the government and institutions were significant factors that influenced the healthcare demand and expenditure of the elderly population.

Health, wealth, and medical expenditures among the elderly in rural Tanzania: Experiences from Nzega and Igunga districts

BackgroundThe per capita health expenditure (HE) and share of gross domestic product (GDP) spending on elderly healthcare are expected to increase. In many developing countries like Tanzania, there is an increasing gap between health needs and the available resources for elderly healthcare, which leaves the elderly with poor health conditions, especially chronic diseases. These conditions lead to catastrophic HEs for the elderly. ObjectiveThis study aimed to analyse the association among health, wealth, and medical expenditure in rural residents aged 60 years and above in Tanzania. MethodsData were collected through a cross-sectional household survey to rural residents aged 60 years and above living in Nzega and Igunga districts. Standardised World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) and European Quality of Life Five Dimension (EQ-5D) questionnaires were used. The quality of life (QoL) was estimated using EQ-5D weights. The wealth index was generated from principal component analysis (PCA). Two linear regression analyses (outpatient/inpatient) were performed to analyse the association among health, wealth, medical expenditure, and socio-demographic variables.ResultsThis study found a negative and statistically significant association between QoL and HE, whereby HE increases with the decrease of QoL. We could not find any significant relationship between HE and social gradients. In addition, age influences HE such that as age increases, the HE for both outpatient and inpatient care also increases.ConclusionThe health system in these districts allocate resources mainly according to needs, and social position is not important. We thus conclude that the system is fair. Health, not wealth, determines the use of medical expenditures.

HOME FOR ELDERLY PEOPLE – FASILITAS KESEHATAN DAN REKREASI LANSIA DI PULOGEBANG

We, basically, as an individual, human beings cannot live in silence, but must travel or wander to get learning about life and the essence of dwelling. However, when humans enter old age, not all things can be done as freely as when they were young, and it causes some elderly individuals to become frustrated with their physical condition which leads to frustration and results in health and psychological problems. Home for Elderly People is a healthcare and recreation facility for the elderly in Pulogebang, where Pulogebang is an area where the largest number of elderly individuals are in East Jakarta and also the existence of middle to lower economic conditions that cause the health of an elderly person to be neglected. Home for Elderly People comes with three main activities, namely, treatment areas, productive areas, and healing areas with ramps, gardens, and age-friendly methods as the main concept in this project. With this project, it is hoped that it can help the elderly to become healthier and more active individuals in the future. Keywords: age-friendly; dwelling; elderly; healthcare; recreation Abstrak Kita pada dasarnya sebagai individu manusia tidak dapat hidup hanya dengan berdiam diri, melainkan harus berpetualang atau berkelana untuk mendapatkan pembelajaran mengenai hidup dan esensi berhuni. Namun ketika manusia memasuki usia tua, tidak semua hal dapat dilakukan dengan bebas sebagaimana ketika berusia muda dan mengakibatkan beberapa individu tua menjadi frustasi akan kondisi fisik mereka yang berujung frustasi dan mengakibatkan gangguan kesehatan dan psikologis. Home for Elderly People merupakan fasilitas kesehatan dan rekreasi bagi lansia di kelurahan Pulogebang, dimana Pulogebang merupakan kawasan yang terdapat keberadaan individu lansia dengan jumlah terbanyak di Jakarta Timur dan juga keberadaan kondisi ekonomi menengah ke bawah yang menyebabkan kesehatan seorang lansia tidak begitu diperhatikan. Home for Elderly People hadir dengan tiga aktivitas utama yaitu, treatment area, productive area, dan healing area dengan ramp, taman, dan metode ramah usia sebagai konsep utama dalam proyek ini. Dengan kehadiran proyek ini diharapkan dapat membantu lansia untuk menjadi individu yang lebih sehat dan aktif di masa depan.

GIS Identifies Elderly Healthcare Centre Future Planning: A Case Study of Local Areas in Northeast of Thailand

Spatial density measures are an important tool for future healthcare planning, particularly in Northeast Thailand where the ageing population has rapidly increased for a decade. The objective of this study was to determine the relationship of geographic and elderly population density in Chiang Yuen district, Mahasarakham province, to ascertain suitable areas for elderly healthcare centres. The data of the elderly located in the villages were collected by the Global Position System (GPS) using Kernel density method to employ the analysis of population density, and GIS for healthcare mapping, and Analytical Hierarchy Process (AHP) as multiple criteria decision-making tools. Factors were determined by using the overlay analysis method, where social, physical and economic factors were variables of interest that were used for the analysis of suitable areas for Elderly Healthcare Centres. The results revealed that the spatial density of the elderly population could be divided into four levels: Low density for the agriculture areas, medium density for agricultural areas including small villages. High density for the areas near communities and public area services and highest density for the centre of towns. The most suitable area was an area with many elderly inhabitants in the community, near transportation routes including main highways leading to other areas. In conclusion, the results confirmed that the density of elderly and proximity to both local stores and transport would make the lower part of Chiang Yuen Sub-district a suitable area to establish a healthcare centre for the elderly, therefore, the authorities and stakeholders should recognise this in planning.

Differences between the Sexes in the Relationship between Chronic Pain, Fatigue, and QuickDASH among Community-Dwelling Elderly People in Japan

Chronic pain and fatigue have negative effects on the health, ADL, work, and hobbies of the elderly. As the proportion of people 65 years of age and older in the population increases, chronic pain and disability research regarding this group is receiving more consideration. However, little empirical evidence of the association between chronic pain, fatigue, and physical disability between the sexes is available. This study investigated the association between chronic pain, fatigue, and instrumental activities of daily living among community-dwelling elderly people by sex in Japan. Concerning the presence of chronic pain, 61% of males and 78% of females reported chronic pain, indicating that many elderly people living in the community suffer from chronic pain and fatigue on a daily basis. The number of sites of chronic pain was higher in females than in males (p = 0.016), with more chronic pain in the knees (p < 0.001) and upper arms (p = 0.014). Regarding chronic pain, males showed a higher correlation with QuickDASH-DS (rs = 0.433, p = 0.017) and QuickDASH-SM (rs = 0.643, p = 0.018) than females. Furthermore, fatigue also showed a higher correlation with QuickDASH-W (rs = 0.531, p = 0.003) in males than in females. These results indicate that the association between chronic pain, fatigue, and QuickDASH differed between the sexes among community-dwelling elderly people in Japan. A better understanding of the risk factors for elderly chronic pain and fatigue among sexes will facilitate the development of elderly healthcare welfare and policies.

OPPNets and Rural Areas: An Opportunistic Solution for Remote Communications

Many rural areas along Spain do not have access to the Internet. Despite the huge spread of technology that has taken place during recent years, some rural districts and isolated villages have a lack of proper communication infrastructures. Moreover, these areas and the connected regions are notably experiencing a technological gap. As a consequence of this, the implementation of technological health solutions becomes impracticable in these zones where demographic conditions are especially particular. Thus, inhabitants over 65 suppose a large portion of such population, and many elderly people live alone at their homes. These circumstances also impact on local businesses which are widely related to the agricultural and livestock industry. Taking into account this situation, this paper proposes a solution based on an opportunistic network algorithm which enables the deployment of technological communication solutions for both elderly healthcare and livestock industrial activities in rural areas. This way, two applications are proposed: a presence detection platform for elderly people who live alone and an analytic performance measurement system for livestock. The algorithm is evaluated considering several simulations under multiple conditions, comparing the delivery probability, latency, and overhead outcomes with other well-known opportunistic routing algorithms. As a result, the proposed solution quadruples the delivery probability of Prophet, which presents the best results among the benchmark solutions and greatly reduces the overhead regarding other solutions such as Epidemic or Prophet. This way, the proposed approach provides a reliable mechanism for the data transmission in these scenarios.