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Migration appears to be a determinant in health-care utilisation, particularly among the elderly in India. Ageing and migration are essential socio-demographic phenomena in the 21st century for developing and developed countries to establish better public health-care policies. This study aims to focus on the status and determinants of health-care utilisation among elderly migrants who have migrated after attaining the age of 45 and above.

This study used the data from the first wave of the longitudinal ageing study in India (LASI) in 2017–2018. Two outcome variables were used to examine the health-care utilisation, including in-patient and out-patient care. Binary logistic regression was used to explore the predictors of healthcare utilisation in terms of in-patient and out-patient care among the elderly migrant population.

A total of 82.9% of elderly migrants had visited out-patient care when they were sick, whereas 15.3% have used in-patient care. Enabling factors, such as wealth quintile and health insurance, and need factor, such as chronic disease and self-rated health, were more significant factors influencing the health-care utilisation.

This study contributes to our understanding of older migrants’ health-care utilisation. Focussing on this study’s outcome, policymakers and decision makers may consider improving older migrants’ access to health-care by raising their income level, offering local health insurance and health awareness programs.

The purpose of this paper is to estimate the key socio‐economic and demographic factors influencing the utilization of antenatal care services in Ghana.

The paper utilizes the most recent Ghana Demographic and Health Survey (GDHS V) data. The dependent variable is the intensity of utilization (number) of antenatal care visits. Hence, the negative binomial regression is employed to investigate the socio‐economic and demographic correlates of the intensity of antenatal care utilization in Ghana.

The study finds that wealth status, age, ownership of health insurance (especially for rural women), educational attainment, birth order, religion and administrative region of residence are significant predictors of the intensity of antenatal care services utilization. In particular, the utilization rate increases in wealth status. The authors also found significant statistical relationship between residence and antenatal care utilization. This finding reinforces the differences in health facilities between the rural and urban areas of Ghana. The authors did not, however, find evidence for proxies for financial and physical access.

The GDHS survey lacks data on the distance to the nearest health facility where ANC is sought and a variable for the price of ANC visit. Proxies had to be used to capture these variables.

The fact that ownership of health insurance in rural areas increases the number of ANC visits makes it imperative to intensify health insurance awareness and enrollment campaigns in the rural areas so as to bridge the rural‐urban gap in ANC utilization. Also, while the free maternal health care policy for expecting mothers is laudable, a minimum level of wealth is required to induce antenatal care visitations. This is because household wealth status still plays a major role even in a free maternal health regime.

A new finding of the paper is the significant effect that ownership of health insurance has on the utilization of ANC services among rural women. While generally rural women have a lower propensity to use ANC services compared to urban women, the intensity of usage of ANC services tends to increase for rural women who own health insurance.

Population ageing is a demographic transition and burdens every country’s health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab.

This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above.

This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population.

This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences.

Sustainable development goals (SDGs) recognize the importance and interrelation between health and migration. Women migration and health is well researched, yet less attention is paid to their healthcare utilization, especially with regard to overall health and well-being. This paper aims to highlight the gap in the existing literature on health care utilization by women migrants.

A systematic review was carried out following the PRISMA guideline. For the review, the literature was taken from three electronic databases, which were Springer Link, Taylor and Francis and PubMed. From a total of 1,575 studies, seven studies cleared the eligibility screening.

Of seven studies, five were found to focus on the sexual and reproductive health of the women migrants than their general health and well-being, and less attention is paid to health promotion and illness prevention beyond reproductive and sexual health. While, studies on general health have focused on the influence of health status on health care utilization and the influence of health insurance in health care utilization. The review has revealed the disparities faced by migrant women in different countries while seeking health care.

Studies on women migration and health care utilization have largely focused on the reproductive and sexual health needs of women, and this overemphasis often undermines their accessibility and affordability to overall health and well-being. Therefore, the present study has moved away from the concept of sexual and reproductive health tot that of overall health and well-being of women migrants.

The race concordance hypothesis suggests that matching patients and health providers on the basis of race improves communication and patients’ perceptions of health care, and by extension, encourages patients to seek and utilize health care, which may reduce health disparities. However, relatively few studies have examined the impact of race concordance on the utilization of health services. This chapter is grounded on Andersen’s Emerging Model of Health Services Utilization (Phase 4) and extends that model to include race concordance.

The data were collected from a stratified random sample of adult beneficiaries enrolled in North Carolina Medicaid’s primary care case management delivery system in 2006–2007. Propensity score matching techniques were used to sort respondents on their propensity for race concordance and indices were constructed to generate key control variables. Poisson regression was used to examine the impact of race concordance on the utilization of primary care and emergency room care, under the assumption that race concordance would increase the use of primary care and decrease the use of emergency care for minority patients.

While blacks (compared to whites) used less primary care and had more emergency care visits, race concordance was not a statistically significant predictor of either primary care or emergency room use. However, patients’ satisfaction with their primary care providers was associated with significantly fewer primary care and emergency care visits while trust in one’s provider was associated with more primary care visits.

The study findings suggest that the central premises of the race concordance hypothesis require further study to confirm the assumption that better patient – primary care provider relationships result in less utilization of more costly and resource-intensive forms of health care.

The study makes a valuable contribution by expanding the relatively small body of literature dedicated to exploring the impact of race concordance on health services utilization. Additionally, by virtue of researching the experience of Medicaid enrollees, the study controls for health insurance status.

Purpose – This study analyzed individual factors of race and dual eligibility on emergency room (ER) utilization of older adult Medicare patients treated by RHCs in CMS Region 4.

Methodology/approach – A prospective, longitudinal design was employed to analyze health disparities that potentially exist among RHC Medicare beneficiary patients (+65) in terms of ER use. The years of investigation were 2010 through 2012, using mixed multilevel, binary logistic regression.

Findings – This study found that dual eligible RHC patients utilized ER services at higher rates than nondual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively.

Research limitations/implications – Regarding limitations, cohort data observations within the window of 3 years were only analyzed; regarding generalizability, in different CMS regions, results will likely vary; and linking other variables together in the study was limited by the accessible data. Future research should consider these limitations, and attempt to refine. The findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in CMS Region 4.

Originality/value – In terms of ER utilization disparities, persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 years and over may be twice as likely to utilize ER services for care than their counterparts in the Southeastern United States.

The paper defines the concept of inequity in health care and reviews the various approaches to identify causal relationships which lead to inequitable health outcomes. Notably, the input and process of health care delivery, the medical and social need factors, the external environment and the indirect influences channeled through ‘mediating’ factors. It further proposes a comprehensive model which integrates the combined effects of the several categories of components involved in determining inequitable outcomes between groups and individuals. While not exhaustive, the model provides a systematic attempt to define and trace inequities in health and potential causes of such, in operational terms. It can be used, therefore, for practical measurement of levels of inequity in outcomes.

The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization.

The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care.

Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors.

This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access.

The research offers a tactical framework for management to segment consumer markets more effectively.

Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome.

The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.

The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.

Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.

To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330