Exploring Socioeconomic and Geographic Drivers of Outpatient Costs in India's Aging Population.

BACKGROUND: Older adults are frequent users of outpatient services, increasing their vulnerability to high healthcare expenditures. OBJECTIVES: This study aimed to investigate the outpatient cost burden among older adults while considering socioeconomic and geographic variations from a rural urban standpoint. MATERIALS AND METHODS: The study included 34,801 Indian older adults (45 years and older) who sought outpatient care within a year before the Longitudinal Ageing Study in India, 2017-2018 survey. Rural-urban distributions by background characteristics and healthcare responsiveness were analyzed using a bivariate Chi-square test. Generalized linear models were used to examine the various factors associated with out-of-pocket expenditure. RESULTS: The habitat of urban areas reported a higher proportion of females and private healthcare usage as compared to rural areas. Cardiovascular and endocrine diseases are prevalent in urban regions, while musculoskeletal and respiratory diseases are prevalent in rural regions, but the most expensive is cancer. Wealthier individuals, females, and private healthcare users reported higher healthcare expenditures. Certain geographical barriers, such as longer distances to facilities, significantly increase the healthcare costs. CONCLUSION: The study highlights the high reliance on private outpatient care by older Indians and identifies education, wealth status, insurance, and geographical access as critical determinants of healthcare expenditure. In this context, strengthening public healthcare infrastructure, integrating telemedicine, and integrating outpatient care in insurance are essential to mitigate these costs. Further research is necessary to examine how women and the rural population perceive healthcare expenditures, as well as their experiences and coping mechanisms.