Cent Eur J Public Health 2009, 17(2):64-70 | DOI: 10.21101/cejph.a3509

Accessibility and Use of Health Services Among Older Estonian Population

Kaja Põlluste1, Ruth Kalda2, Margus Lember1
1 Department of Internal Medicine, University of Tartu, Estonia
2 Department of Family Medicine, University of Tartu, Estonia

The aim of the study was to analyse the self-reported use of health services among the older Estonian population, to explain the predictors of health care utilisation and to study access to health services in comparison with other population groups. In November 2005, a randomly sampled Estonian residents aged 15-64 (n=1264) and 65-74 (n=182) was personally interviewed using structured questionnaires. Of the respondents aged 65-74, 81% reported having visited a general practitioner (GP) or specialist during the previous 12 months. Compared to younger people they used health services more often, except dental care. No significant differences were found in comparison with the waiting times to see the general practitioner or specialist between the younger and older population groups. Compared to the rest of the population people aged 65-74 were more satisfied with their access to health services. The probability of visiting a GP was higher for those respondents who had health problems and lived in rural areas. The presence of chronic illness also had an effect on the use of specialist services and ambulance services. Higher education, living in an urban area and having a family member with a chronic illness predicted the use of ambulance services as well. Younger age, higher income and higher education were predictors of the use of dental services. The availability of and access to health services for older people in Estonia are comparable with other groups of the population.

Keywords: elderly, health services, utilisation, access

Received: July 10, 2008; Revised: February 16, 2009; Accepted: February 16, 2009; Published: June 1, 2009  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Põlluste K, Kalda R, Lember M. Accessibility and Use of Health Services Among Older Estonian Population. Cent Eur J Public Health. 2009;17(2):64-70. doi: 10.21101/cejph.a3509. PubMed PMID: 19662822.
Download citation

References

  1. Statistics Estonia [homepage on the Internet]. Tallinn: Statistical Office of Estonia [cited 2009 Jan 30]. Available from: http://www.stat.ee.
  2. Noro AM, Häkkinen UT, Laitinen OJ. Determinants of health service use and expenditure among the elderly Finnish population. Eur J Public Health. 1999 Sep;9(3):174-80. Go to original source...
  3. FreebornDK,PopeCR,MulloolyJP,McFarlandBH.Consistentlyhighusers of medical care among the elderly. Med Care. 1990 Jun;28(6):527-40. Go to original source... Go to PubMed...
  4. Ležovič M, Raučinová M, Kováč A, Moricová Š, Kováč R. Long-term care in developed countries and recommendations for Slovak Republic. Centr Eur J Public Health. 2008 Mar;16(1):21-5. Go to original source...
  5. Suominen-Taipale AL, Koskinen S, Martelin T, Holmen J, Johnsen R. Differences in older adults' use of primary and specialist care services in two Nordic countries. Eur J Public Health. 2004 Dec;14(4):375-80. Go to original source... Go to PubMed...
  6. WanTTH, Odell BG. Factors affecting the use of social and health services among the elderly. Ageing Soc. 1981 Mar;1(1):95-115. Go to original source...
  7. Põlluste K, Kalda R, Lember M. Evaluation of primary health care reform in Estonia from patients'perspective: acceptability and satisfaction. Croat Med J. 2004 Oct;45(5):582-7. Go to PubMed...
  8. Saks K, Kolk H, Allev R, Soots A, Kõiv K, Paju I, et al. Health status of the older population in Estonia. Croat Med J. 2001 Dec;42(6):663-8. Go to PubMed...
  9. Kalda R, Põlluste K, Maaroos HI, Lember M. Patients'opinions on family doctor accessibility in Estonia. Croat Med J. 2004 Oct;45(5):578-81. Go to PubMed...
  10. Habicht J, Xu K, Couffinhal A, Kutzin J. Detecting changes in financial protection: creating evidence for policy in Estonia. Health Policy Plan. 2006 Nov;21(6):421-31. Go to original source... Go to PubMed...
  11. Põlluste K, Kalda R, Lember M. Primary health care system in transition: the patient's experience. Int J Qual Health Care. 2000 Dec;12(6):503-9. Go to original source...
  12. Kalda R, Põlluste K, Lember M. Patient satisfaction with care is associated with personal choice of physician. Health Policy. 2003 Apr;64(1):55-62. Go to original source...
  13. Põlluste K, Kalda R, Lember M. Satisfaction with access to health services of people with chronic conditions in Estonia. Health Policy. 2007 Jun;82(1):51-61. Go to original source... Go to PubMed...
  14. Heenan D. Factors influencing access to health and social care in the farming communities of County. Down, Northern Ireland. Ageing Soc. 2006;26(3):373-91. Go to original source...
  15. Davidová J, Ivanovic N, Práznovcová L. Participation in pharmaceutical costs and seniors' access to medicines in Czech Republic. Cent Eur J Public Health. 2008 Mar;16(1):26-8. Go to original source...
  16. Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006 Jul;96(7):1300-7. Go to original source... Go to PubMed...
  17. McCusker J, Verdon J. Do geriatric interventions reduce emergency department visits? A systematic review. J Gerontol A Biol Sci Med Sci. 2006 Jan;61(1):53-62. Go to original source...
  18. Clark MJ, FitzGerald G. Older people's use of ambulance services: a population based analysis. J Accid Emerg Med. 1999 Mar;16(2):108-11. Go to original source...
  19. Dundar C, Sunter AT, Canbaz S, Cetinoglu E. Emergency service use by older people in Samsun, Turkey. Adv Ther. 2006 Jan-Feb;23(1):47-53. Go to original source...
  20. McCusker J, Karp I, Cardin S, Durand P, Morin J. Determinants of emergency department visits by older adults: a systematic review. Acad Emerg Med. 2003 Dec;10(12):1362-70. Go to original source...
  21. Oterino de la Fuente D, Baños Pino JF, Blanco VF, Alvarez AR. Does better access to primary care reduce utilisation of hospital accident and emergency departments? A time-series analysis. Eur J Public Health. 2007 Apr;17(2):186-92. Go to original source... Go to PubMed...