JMIR Publications

ABSTRACT

Background:

There is limited evidence on the patterns of healthcare utilization among older adults in Singapore over the past decade.

Objective:

This study examines whether the proportion of specific services used within sociodemographic subgroups, factors associated with healthcare utilization, and network structure of the healthcare utilization has changed over a decade.

Methods:

We used data from two repeated nationwide cross-sectional surveys of Singapore residents aged 60 years and above, conducted in 2013 (n=2,565) and 2023 (n=2,010). Healthcare service utilization was obtained from an adapted version of the Client Service Receipt Inventory and analysed using multivariable logistic regression and network analysis.

Results:

The most significant changes between 2013 and 2023 were the proportion of older adults who had consulted private hospital/clinic doctors (decreased by 4.6%), consulted public and private dentists (increased by 6.4%), and had health insurance (increased by 26%), including MediShield and ElderShield schemes. Those diagnosed with high blood pressure and diabetes were more likely to consult primary care doctor services, while those diagnosed with dementia and heart problems were more likely to consult public hospital doctors and health workers in both 2013 and 2023. We also found that those diagnosed with dementia were more likely to visit emergency departments and require hospitalization services in both 2013 and 2023. Network analysis revealed that there were strong connections between respite care, nursing homes, and hospital admissions in 2023.

Conclusions:

This study provides important data on population-level changes in healthcare utilization among older adults across a decade from 2013 to 2023 which will help policy makers to ensure better healthcare delivery for older adults. Clinical Trial: NA