Joel Negin1, Madeleine Randell1, Magdalena Z Raban2, Makandwe Nyirenda3,4, Sebastiana Kalula5,6, Lorna Madurai7, Paul Kowal8,9. 1. a Sydney School of Public Health , University of Sydney , Sydney , Australia. 2. b Centre for Health Systems and Safety Research , Australian Institute of Health Innovation, Macquarie University , Sydney , Australia. 3. c Africa Centre for Health and Population Studies , University of KwaZulu-Natal , Mtubatuba , South Africa. 4. d School of Social Sciences , University of Southampton , Southampton , UK. 5. e Division of Geriatric Medicine , The Albertina and Walter Sisulu Institute of Ageing in Africa, University of Cape Town , Cape Town , South Africa. 6. f Groote Schuur Hospital, International Longevity Centre , Cape Town , South Africa . 7. g Global Clinical and Viral Laboratories , Durban , South Africa. 8. h Research Centre for Gender, Health & Ageing , University of Newcastle , Newcastle , Australia. 9. i World Health Organization, SAGE , Geneva , Switzerland.
Abstract
INTRODUCTION: The burden of HIV is increasing among adults aged over 50, who generally experience increased risk of cormorbid illnesses and poorer financial protection. We compared patterns of health utilisation and expenditure among HIV-positive and HIV-negative adults over 50. METHODS: Data were drawn from the Study on global AGEing and adult health in South Africa with analysis focusing on individual and household-level data of 147 HIV-positive and 2725 HIV-negative respondents. RESULTS: HIV-positive respondents reported lower utilisation of private health-care facilities (11.8%) than HIV-negative respondents (25.0%) (p = .03) and generally had more negative attitudes towards health system responsiveness than HIV-negative counterparts. Less than 10% of HIV-positive and HIV-negative respondents experienced catastrophic health expenditure (CHE). Women (OR 1.8; p < .001) and respondents from rural settings (OR 2.9; p < .01) had higher odds of CHE than men or respondents in urban settings. Over half the respondents in both groups indicated that they had received free health care. CONCLUSIONS: These findings suggest that although HIV-positive and HIV-negative older adults in South Africa are protected to some extent from CHE, inequalities still exist in access to and quality of care available at health-care services - which can inform South Africa's development of a national health insurance scheme.
INTRODUCTION: The burden of HIV is increasing among adults aged over 50, who generally experience increased risk of cormorbid illnesses and poorer financial protection. We compared patterns of health utilisation and expenditure among HIV-positive and HIV-negative adults over 50. METHODS: Data were drawn from the Study on global AGEing and adult health in South Africa with analysis focusing on individual and household-level data of 147 HIV-positive and 2725 HIV-negative respondents. RESULTS: HIV-positive respondents reported lower utilisation of private health-care facilities (11.8%) than HIV-negative respondents (25.0%) (p = .03) and generally had more negative attitudes towards health system responsiveness than HIV-negative counterparts. Less than 10% of HIV-positive and HIV-negative respondents experienced catastrophic health expenditure (CHE). Women (OR 1.8; p < .001) and respondents from rural settings (OR 2.9; p < .01) had higher odds of CHE than men or respondents in urban settings. Over half the respondents in both groups indicated that they had received free health care. CONCLUSIONS: These findings suggest that although HIV-positive and HIV-negative older adults in South Africa are protected to some extent from CHE, inequalities still exist in access to and quality of care available at health-care services - which can inform South Africa's development of a national health insurance scheme.
Entities:
Keywords:
HIV; South Africa; catastrophic health expenditure; health expenditure; older adults
Authors: Samuel López-López; Raúl Del Pozo-Rubio; Marta Ortega-Ortega; Francisco Escribano-Sotos Journal: Int J Environ Res Public Health Date: 2021-01-21 Impact factor: 3.390
Authors: Raúl Del Pozo-Rubio; Isabel Pardo-García; Francisco Escribano-Sotos Journal: Int J Environ Res Public Health Date: 2020-01-01 Impact factor: 3.390
Authors: Jeffrey V Lazarus; Kelly Safreed-Harmon; Adeeba Kamarulzaman; Jane Anderson; Ricardo Baptista Leite; Georg Behrens; Linda-Gail Bekker; Sanjay Bhagani; Darren Brown; Graham Brown; Susan Buchbinder; Carlos Caceres; Pedro E Cahn; Patrizia Carrieri; Georgina Caswell; Graham S Cooke; Antonella d'Arminio Monforte; Nikos Dedes; Julia Del Amo; Richard Elliott; Wafaa M El-Sadr; María José Fuster-Ruiz de Apodaca; Giovanni Guaraldi; Tim Hallett; Richard Harding; Margaret Hellard; Shabbar Jaffar; Meaghan Kall; Marina Klein; Sharon R Lewin; Ken Mayer; Jose A Pérez-Molina; Doreen Moraa; Denise Naniche; Denis Nash; Teymur Noori; Anton Pozniak; Reena Rajasuriar; Peter Reiss; Nesrine Rizk; Jürgen Rockstroh; Diana Romero; Caroline Sabin; David Serwadda; Laura Waters Journal: Nat Commun Date: 2021-07-16 Impact factor: 14.919