India has home to 138 million elderly people and has witnessed a rapid population shift, with the proportion of the population aged 60 and older increasing from 7.4% in 2001 to an estimated 13.2% in 2031. File Photos | Photo Source: ragu r
Even in the universal healthcare system, the distinctive difference in care continues among older people, distance from healthcare facilities poses a key barrier. Lancet Regional Sanitation Southeast Asia Title “The miles I’ll walk before I seek: the distance between medical facilities and health care for seniors in India”. It further pointed out that ensuring that health services are available and reducing geographical barriers is crucial to ensure a fair and inclusive healthcare system that no one has left behind.
The study notes that while many studies have explored financial restrictions and health literacy as barriers to health care acquisition, limited evidence shows how physical distancing in older Indians affects health care utilization and health-seeking behaviors. In this article, the researchers used the Nationally Representative Longitudinal Aging Study (Wave-1, 2017-18) from India (LASI), which consisted of data from 31,902 older adults to analyze the conventional and acute health care needs and the average distance to reconcile health care in older adults.
Distance travel
In India, access to health care is often limited by factors such as local health services, financial constraints, low health literacy, and insufficient family or social support systems. India has home to 138 million elderly people and has witnessed a rapid population shift, with the proportion of the population aged 60 and older increasing from 7.4% in 2001 to an estimated 13.2% in 2031. Nearly half of these populations have multiple long-term or debilitating conditions that require continuous and coordinated health care.
The study noted that the elderly traveled an average of 14.54 kilometers to seek outpatient services and 43.62 kilometers of inpatient care. For two-thirds (67%) of urban older adults, the available outpatient facilities are within 10 km of coverage, while for rural areas, this is 28.3 km, revealing significant urban and rural differences. This has increased disproportionately for inpatient care, with rural Sexagenarians twice as far and time as compared to their urban counterparts. For hospitalization, 95% arranged their own mode of transportation, while 5% of ambulance services did not have significant urban-rural differences.
When the facility is within 10 km distance, the utilization rate of outpatient and inpatient care is high (73% and 40% respectively). As distances increase, a corresponding decrease in outpatient utilization was observed, with facilities of 11-30 km and facilities of 30 km or higher of 17% and 10%. Furthermore, this decline is even more pronounced for women, women living alone, and those with low education and income. About 19% of rural elderly people must travel at least 60 kilometers to enjoy inpatient care. This is similar for urban residents, with 10% of travel requiring at least 60 kilometers of hospitalization.
Risk of adverse outcomes
The study adds that long travel times and distant facilities are potential barriers to timely and basic health care for this population, which can pose a high risk of adverse outcomes, adding that addressing transportation barriers may be a key strategy for improving access to care for older doctors, especially those living in rural areas.
“Various studies show that interventions aimed at minimizing transportation barriers in low-income, distant and older populations can not only improve access to health care, but also improve patient outcomes while being cost-effective. Future research must develop and demonstrate how community-based transportation services can be embedded in internal models to implement temporary people, which are temporary models of temporary models, given temporary models, given temporary models of people. This study suggests that through a mix of mobile health vans, digital health care and inclusive social support, the case is considered.”
It added that it is necessary to design and develop strategies on how to strengthen the existing Ayushman Arogya Mandir (community-based primary care center) to meet the comprehensive health care needs of the growing older population.
publishing – April 23, 2025 at 10:50 am IST
