Associations between Healthcare Utilization and Quality of Life of Older Adults with Non-communicable Diseases in Rural Sri Lanka

Abstract

Background: The prevalence of non-communicable diseases (NCD) is high in older adults. Such chronic conditions together with poor healthcare utilization would lead to poor quality of life (QoL) in older adults. In the Sri Lankan context, the associations between these factors are not known. Objective: To determine the association between utilization of healthcare services and QoL of older adults (aged 60+ years) with NCDs, living in rural Sri Lanka Methods: A cross-sectional study was conducted recruiting 324 participants. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire was used to measure QoL of older adults with four domains; physical health, psychological health, social relationships, and environmental health. A self-administered questionnaire was developed and used to collect required socio-demographic information. Data were analysed using SPSS version 25.0. Results: A total of 324 older adults with NCDs were participated in this study. The age range was 61-97 years (mean±SD; 70.53±7.42). Among them, 138 (42.6%) were men. In the study sample, the prevalences of hypertension, diabetes, asthma, and arthritis were 60.8%, 42.3%, 16.7%, and 12.3%, respectively. About 81.0% of older adults with NCDs visit allopathic clinics at least once a month and about 8.0% of older adults with NCDs visit Ayurvedic doctors at their clinics at least once a month. The mean (±SD) score (out of 100) of QoL for Physical, psychological, social, and environmental domains of the participants were 56.53 (±9.93), 55.78 (±10), 63.76 (±16.57), and 61.32, (±10.92), respectively. The QoL of older adults were not vary by the frequency of their doctor visits, except for social dimension of QoL. The social QoL was higher among those who attend regular doctor visits. Conclusion: A high proportion of older adults with NCDs seems to utilize allopathic healthcare services on a regular basis. Although the QoL was satisfactory in most of the older adults with NCDs, attention should be paid to improving their physical and psychological QoL. Keywords: Health care utilization, Non-communicable diseases, Older adults, Quality of life, Rural Sri Lanka 57