Determinants of Utilization of Healthcare Services among Older Adults in a Selected Local Government Area of Lagos, Nigeria: A Cross-Sectional Study

Abstract

Background: Population ageing has increased the demand for healthcare services, challenging fragile healthcare systems globally. In Nigeria, healthcare utilization rates by older adults remain low compared to other subgroups. This study aimed to identify the factors that influence healthcare use among older adults in a selected Local Government Area of Lagos, Nigeria.

Methods: A cross-sectional study design using interviewer-administered, semistructured questionnaires was used to collect data from 250 respondents recruited by multistage sampling, from July to September 2023. Descriptive statistics, the Chi-square test and sequential logistic regression were employed to analyze associations and predictors of healthcare utilization.

Results: Of the 250 respondents, 132 (52.8%) were female, 127 (50.8%) were married, and 202 (80.8%) utilized healthcare services in the past year. Predisposing factors associated with utilization included Community of residence (Community C: 89.4% vs. A: 69.6%, p < 0.01) and religion (Christians: 87.7% vs. Traditionalists: 46.7%, p < 0.01). Enabling factors showed stronger associations: education (tertiary: 96.2% vs. none: 51.2%, p < 0.001), employment (Employed: 77.4% vs. Unemployed: 94.1%, p < 0.01), income (≥₦40,000: 94% vs. <₦20,000: 65.4%, p < 0.001), and health insurance (insured: 89.1% vs. uninsured: 74.3%, p < 0.01). Chronic illnesses didn’t significantly influence utilization. After adjustments, higher education (AOR = 1.92, 95% CI: 1.24–2.98) and income (AOR = 1.60, 95% CI: 1.03–2.49) were strong predictors of healthcare use.

Conclusion: Improving healthcare utilization among older adults will require effectively implementing age-responsive healthcare policies, strengthening enabling factors, and eliminating physical and financial barriers to healthcare access.