Novel assessment reveals poorer health system responsiveness for older adults with limitations and low socio-economic status in India, suggesting systemic ableism.
Key Points
To evaluate health system responsiveness among older adults with functional limitations and socio-economic vulnerability in India.
Analyzed data from the Longitudinal Ageing Study in India Wave 1 (2017-2018) with 16,659 older adults for outpatient and 2,358 for inpatient care.
Used multivariable linear regressions to assess the association between HSR and functional limitations, multimorbidity, and socio-economic factors.
Calculated overall HSR score by summing across six domains: prompt attention, dignity, communication, confidentiality, choice of providers, and quality of amenities.
Median HSR score was 24 (range 6-30), equivalent to approximately 75 on a 0-100 scale for outpatient and inpatient care.
Older adults with functional limitations experienced poorer responsiveness in outpatient (β = -0.62; 95%CI: -0.84, -0.41) and inpatient care (β = -0.62; 95%CI: -1.14, -0.09).
Lower castes and lower economic status reported poorer responsiveness among those with functional limitations.