THE HEALTH-CARE NEEDS AMONG OLDER PERSONS IN AN INDONESIAN URBAN SETTING
Objective: The unmet health-care needs among older persons population should be identified and anticipated due to hideous potential impacts. Ironically, no published study regarding this phenomenon was found in Indonesia. Derived from the Indonesian population and civil data, this study was conducted to identify the health-care needs of urban older people living on Java Island, the most populated island in Indonesia.
Methods: A qualitative study was conducted in 3 subdistricts in Surabaya, the capital city of East Java, namely, Rungkut, Kenjeran, and Tenggilis. There were 9 focus group discussions (FGDs) conducted during March-August 2015. Participants in this study were recruited purposively, i.e., person in charge of â€œKarang Werda,â€ and the discussion explored thematically various topics in the area of unmet health needs phenomena related to: (1) Availability, (2) accessibility, and (3) acceptability. A FGD guide was developed to ensure in-depth discussion.
Results: There were 90 older persons serving as volunteers who participated in this study. The unmet health-care needs addressed by participants in this study were (1) Integrated and specialized health-care services for older persons and (2) skillful yet age-friendly health-care personnel were needed by participants. Our findings pointed out that the unmet health-care needs in Indonesian urban settings were classified as primarily availability, accessibility, and acceptability issues.
Conclusion: The government needs to take actions to solve the challenges related to the fulfillment of health-care needs among older persons in Indonesia. Further study of the health care personnelâ€™s beliefs and attitudes in providing care among older persons needs to be conducted to provide a more holistic picture of the phenomena before making any strategy for the future Indonesiaâ€™s health-care system.
2. Wandera SO, Kwagala B, Ntozi J. Determinants of access to healthcare by older persons in Uganda: A cross-sectional study. Int J Equity Health 2015;14:26.
3. World Health Organization. Global Health and Aging. Geneva: World Health Organization; 2013.
4. Naughton C, Drennan J, Treacy MP, Lafferty A, Lyons I, Phelan A, et al. Abuse and Neglect of Older People in Ireland: Report on the National Study of Elder Abuse and Neglect. Dublin: National Centre for the Protection of Older People; 2010.
5. Kshetri DB, Smith WC. Self-reported health problems, health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur district of Nepal. Aging Male 2011;14(2):127-31.
6. Dziechciaz M, Guty E, Wojtowicz A, Filip R. Social and health care needs of elderly people living in the countryside in Poland. Ann Agric Environ Med 2012;19(4):746-50.
7. Lena A, Ashok K, Padma M, Kamath V, Kamath A. Health and social problems of the elderly: A cross-sectional study in Udupi taluk, Karnataka. Indian J Community Med 2009;34(2):131-4.
8. Thakur R, Banerjee A, Nikumb V. Health problems among the elderly: A cross-sectional study. Ann Med Health Sci Res 2013;3(1):19-25.
9. Herr M, Arvieu JJ, Aegerter P, Robine JM, Ankri J. Unmet health care needs of older people: Prevalence and predictors in a French cross-sectional survey. Eur J Public Health 2014;24(5):808-13.
10. Gauld R, Raymont A, Bagshaw PF, Nicholls MG, Frampton CM. The importance of measuring unmet healthcare needs. N Z Med J 2014;127(1014):63-7.
11. Long SK, King J, Coughlin TA. The implications of unmet need for future health care use: Findings for a sample of disabled Medicaid beneficiaries in New York. Inquiry 2005;42(4):413-20.
12. Quail JM, Wolfson C, Lippman A. Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: A prospective cohort study. BMC Geriatr 2011;11:86.
13. Puts MT, Papoutsis A, Springall E, Tourangeau AE. A systematic review of unmet needs of newly diagnosed older cancer patients undergoing active cancer treatment. Support Care Cancer 2012;20(7):1377-94.
14. Yamada T, Chen CC, Murata C, Hirai H, Ojima T, Kondo K, et al. Access disparity and health inequality of the elderly: Unmet needs and delayed healthcare. Int J Environ Res Public Health 2015;12(2):1745 72.
15. Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: A literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev 2011;68(2):131-55.
16. Chen J, Hou F. Unmet needs for health care. Health Rep 2002;13(2):23 34.
17. Sanmartin C, Houle C, Tremblay S, Berthelot JM. Changes in unmet health care needs. Health Rep 2002;13(3):15-21.
18. Nelson CH, Park J. The nature and correlates of unmet health care needs in Ontario, Canada. Soc Sci Med 2006;62(9):2291-300.
19. Pappa E, Kontodimopoulos N, Papadopoulos A, Tountas Y, Niakas D. Investigating unmet health needs in primary health care services in a representative sample of the Greek population. Int J Environ Res Public Health 2013;10(5):2017-27.
20. Ahn YH, Kim NH, Kim CB, Ham OK. Factors affecting unmet healthcare needs of older people in Korea. Int Nurs Rev 2013;60(4):510 9.
21. Badan Pusat Statistik East Java Province. Banyaknya Rumah Sakit Umum, Puskesmas dan Puskesmas Pembantu 2010-2013; 2015. Available from: http://www.jatim.bps.go.id/linktablestatis/view/id/309. [Last cited on 2016 Apr 20].
22. The World Bank. Population Ranking; 2015. Available from: http:// www.data.worldbank.org/data-catalog/Population-ranking-table. [Last cited on 2016 Apr 20].
23. Badan Pusat Statistik East Java Province. Profil Penduduk Lanjut Usia Jawa Timur 2014. Surabaya: Badan Pusat Statistik Jawa Timur; 2014.
24. Provincial Office of Ministry of Health. Profil Kesehatan Provinsi Jawa Timur Tahun 2012. Surabaya: Dinas Kesehatan Provinsi Jawa Timur; 2012.
25. Badan Pusat Statistik Surabaya. Banyaknya Penduduk Menurut Jenis Kelamin Per Kecamatan Hasil Registrasi, 2014; 2015. Available from: http://www.surabayakota.bps.go.id/webbeta/frontend/linkTableStatis/ view/id/322. [Last cited on 2016 Apr 20].
26. Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Riset Kesehatan Dasar (RISKESDAS) 2013; 2013. Available from: http://www.depkes.go.id/resources/download/general/Hasil%20 Riskesdas%202013.pdf. [Last cited on 2016 Apr 20].
27. Upadhyay J, Joshi Y. Observation of drug utilization pattern and prevalence of diseases in elderly patients through home medication review. Asian J Pharm Clin Res 2011;4(1):143-5.
28. Jerez-Roig J, Medeiros LF, Silva VA, Bezerra CL, Cavalcante LA, Piuvezam G, et al. Prevalence of self-medication and associated factors in an elderly population: A systematic review. Drugs Aging 2014;31(12):883-96.
29. Goh LY, Vitry AI, Semple SJ, Esterman A, Luszcz MA. Self-medication with over-the-counter drugs and complementary medications in South Australiaâ€™s elderly population. BMC Complement Altern Med 2009;9:42.
30. Zheng L, Du X. Non-steroidal anti-inflammatory drugs and hypertension. Cell Biochem Biophys 2014;69(2):209-11.
31. Mekonnen AB, Bhagavathula AS. Inappropriate medication use in the elderly population attending Gondar University Hospital: A preliminary assessment. Int J Pharm Pharm Sci 2014;6(10):540-3.
32. Chowta MN, Adhikari PM, Raj S, Laxman M, Kariappa A, George J, et al. Evaluation of appropriateness of prescription and polypharmacy in the geriatric population: A cross-sectional study at a comprehensive geriatric clinic in a tertiary care hospital. Int J Pharm Pharm Sci 2016;8(3):119-23.
33. Tavares NU, Bertoldi AD, ThumÃ© E, Facchini LA, FranÃ§a GV, Mengue SS. Factors associated with low adherence to medication in older adults. Rev Saude Publica 2013;47(6):1092-101.
34. Aikens JE, Piette JD. Longitudinal association between medication adherence and glycaemic control in Type 2 diabetes. Diabet Med 2013;30(3):338-44.
35. Nagrebetsky A, Griffin S, Kinmonth AL, Sutton S, Craven A, Farmer A. Predictors of suboptimal glycaemic control in Type 2 diabetes patients: The role of medication adherence and body mass index in
the relationship between glycaemia and age. Diabetes Res Clin Pract 2012;96(2):119-28.
36. Matsumura K, Arima H, Tominaga M, Ohtsubo T, Sasaguri T, Fujii K, et al. Impact of antihypertensive medication adherence on blood pressure control in hypertension: The COMFORT study. QJM 2013;106(10):909-14.
37. Emdin CA, Rahimi K, Neal B, Callender T, Perkovic V, Patel A. Blood pressure lowering in Type 2 diabetes: A systematic review and meta-analysis. JAMA 2015;313(6):603-15.
38. Solli O, Stavem K, Kristiansen IS. Health-related quality of life in diabetes: The associations of complications with EQ-5D scores. Health Qual Life Outcomes 2010;8:18.
39. Wang W, Fu CW, Pan CY, Chen W, Zhan S, Luan R, et al. How do Type 2 diabetes mellitus-related chronic complications impact direct medical cost in four major cities of urban China? Value Health 2009;12(6):923-9.
40. Potter C. What quality healthcare means to older people: Exploring and meeting their needs. Nurs Times 2009;105(49-50):14-8.
41. Beverly EA, Wray LA, Chiu CJ, LaCoe CL. Older adultsâ€™ perceived challenges with health care providers treating their Type 2 diabetes and comorbid conditions. Clin Diabetes 2014;32(1):12-7.
42. Holt E, Joyce C, Dornelles A, Morisky D, Webber LS, Muntner P, et al. Sex differences in barriers to antihypertensive medication adherence: Findings from the cohort study of medication adherence among older adults. J Am Geriatr Soc 2013;61(4):558-64.
43. Reader TW, Gillespie A. Patient neglect in healthcare institutions: A systematic review and conceptual model. BMC Health Serv Res 2013;13:156.
44. Ministry of Health Republic of Indonesia. Indonesia Health Profile 2013. Jakarta: Ministry of Health Republic of Indonesia; 2014.
45. Samra R, Griffiths A, Cox T, Conroy S, Gordon A, Gladman JR. Medical studentsâ€™ and doctorsâ€™ attitudes towards older patients and their care in hospital settings: A conceptualisation. Age Ageing 2015;44(5):776-83.
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