How far is my hospital? In India, it's 15 kms for OPD, 44 kms for admission

Older adults in India are travelling considerable distances to access healthcare, with some commuting up to 15 kilometres for outpatient visits and nearly 44 kilometres for hospitalisation, according to new research.

The study, published in The Lancet Regional Health – Southeast Asia, highlights sharp urban-rural disparities in healthcare access. While seniors in urban areas typically accessed outpatient services within 10 kilometres, their rural counterparts had to travel nearly three times as far, the researchers found.

The findings are based on data from nearly 32,000 individuals aged 60 and above, surveyed during the first wave of the Longitudinal Ageing Study of India (LASI) in 2017-2018. India’s elderly population, currently estimated at 138 million, is projected to rise from 7.4% of the total population in 2001 to 13.2% by 2031.

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The study also noted that proximity plays a critical role in healthcare usage: 73% of older adults accessed outpatient services and 40% used inpatient care when facilities were located within 10 kilometres.

However, with an increase in commute distance, a commensurate decline in the use of out-patient services was found – 17 per cent utilisation of facilities for 11-30 kilometres distance, and 10 per cent for 30 kilometres and above, respectively.

A longer commute and far placed facility is a barrier for receiving timely, essential healthcare for people in this age group, often seen grappling with multiple long-term, debilitating conditions requiring continuous care, the team said.

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They wrote, “Older adults, on an average travelled a distance of nine miles (14.54 kilometres) to seek outpatient services and 27 miles (43.62 kilometres) for inpatient care respectively.” State-wise, Tripura, Manipur and Kerala, had the highest in-patient and outpatient visits within 10 kilometres – over 80 per cent, 75 per cent and 59 per cent of older adults availed in-patient services, respectively, while 88 per cent, 78 per cent and 84 per cent availed out-patient ones, respectively

.The authors attributed Kerala’s high rates to “easy access and better availability of infrastructure”. In Manipur and Tripura, it may be because people rely on nearby facilities during emergency in-patient situations, they said.

Hilly states such as Nagaland, Sikkim and Himachal Pradesh could pose geographical challenges as zero per cent, 17 per cent and about five per cent of older adults in these areas made in-patient visits within 10 kilometres, the study found.

Further, in northeastern states, such as Mizoram and Nagaland, a higher percentage of older adults were found to travel more than 60 kilometres to access in-patient and out-patient services, indicating a poor and limited access to nearby facilities.

Uttar Pradesh, Bihar, and Madhya Pradesh showed a moderate proximity of 11-60 kilometres for older adults accessing out-patient care, but a higher share of in-patient visits at distances beyond 30 kilometres.

The authors added that less variability in commute distance among southern states indicated a well-distributed healthcare infrastructure. For an equitable and inclusive healthcare system in India, improving access to services and reducing geographical barriers are paramount, the team said.

With inputs from agencies