Healthcare Utilization by Older Age Groups in Northern States of Peninsular Malaysia: The Role of Predisposing, Enabling and Need Factors.

Determining factors that affect healthcare utilization by the elderly is vital for the health system to be more responsive in providing care to this vulnerable group. The main objective of this paper is to identify the effect of the predisposing, enabling, and need factors on doctor visits and in-patient care for the elderly residing in the northern region of Malaysia. A multistage cluster sampling was used in selecting the sample for the study. A total of 1414 respondents aged 60 and over were interviewed face-to-face using a structured questionnaire. A probit model was used in estimating the utilization equations. At a significance level of 0.05, except for age, all predisposing and enabling factors were not statistically significant in affecting the doctor visits. On the other hand, being a male, smoker, medical insurance holder or had not actively involved in social interaction within the reference period increases the likelihood of being in-patient. Health-related variables remain the most significant factors that determine healthcare utilization, including both doctor visits and in-patient stays, in the area of study, which suggests that government policies to improve population health may influence the level of healthcare use in the future.