Multidimensional Challenges and Healthcare Access among the Elderly in India: A Cross-Sectional Study

Abstract

Background: India is experiencing a rapid demographic transition with a growing elderly population facing complex social, economic, and health-related challenges. Despite the increasing burden of multimorbidity and disability, limited research explores how multidimensional factors influence healthcare access among older adults. Objectives: This study aimed to assess the multifaceted challenges faced by elderly individuals and to examine the associations between these challenges and the affordability of healthcare services in Patna, Bihar. Methods: A community-based cross-sectional study was conducted from July to December 2024 among 200 elderly individuals aged ≥60 years in urban and semi-urban areas of Patna district. Participants were selected using purposive sampling. Data were collected using a pre-tested, semi-structured interview schedule and analysed using SPSS v25. Descriptive statistics summarized key variables, and chi-square tests examined associations between healthcare affordability and selected determinants. Results: Among participants, 55% were female and 51% were widowed; 47.5% lived below the poverty line. A large proportion reported inadequate housing (59%), social isolation (72%), and mobility issues (55%). Healthcare services were unaffordable for 64.5% of respondents. Significant associations were found between healthcare affordability and housing adequacy (p<0.001), financial status (p<0.001), mobility (p<0.001), living arrangement (p<0.001), and social support (p<0.001). Conclusion: Healthcare affordability among the elderly is strongly influenced by multiple interrelated social, economic, and physical factors. Policies aiming to improve elderly healthcare must adopt a multidimensional approach that includes improving living conditions, financial security, social support, and mobility assistance to promote healthy and equitable ageing in India.