Factors Influencing Healthcare Facility Choice Among Older Adults in Ekiti, Nigeria: Implications for Health Literacy

Abstract

Introduction: Healthcare facility choice among older adults is a reflection of individual capacities and health system characteristics. Understanding the key determinants of this choice is very important for improving access and equity in healthcare delivery especially low- and middle-income countries with limited resources. Objective: This study was designed to identify the sociodemographic and health system factors associated with healthcare facility choice among older adults in Ekiti State, Southwest Nigeria. Methods: A hospital-based cross-sectional study was conducted among community dwelling older adults aged 60 years and above. Data were collected using structured interviewer administered questionnaire. Information sought included sociodemographic characteristics, healthcare utilization patterns, and facility choice. Healthcare facilities were classified into primary, secondary/tertiary, and private hospitals. Inferential statistics were performed to identify factors associated with facility choice. Results: Secondary/tertiary public hospitals were the most commonly utilized among older adults. Educational attainment was the only sociodemographic factor significantly associated with healthcare facility choice with higher levels of education associated with greater use of secondary/tertiary facilities. Conclusion: Educational attainment plays an important role in determining healthcare facility choice among older adults in Ekiti State. This underscores the importance of health literacy in later life. Interventions aimed at equitable utilization of public health facilities should incorporate health literacy and the three-tier nature of Nigerian healthcare system. Keywords: Healthcare facility choice; older adults; influencing factors; health literacy.