Crossroads of Inequality: Health of Elderly Populations and Access to Healthcare

Author(s): N. Chikhladze*1, N. Pitskhelauri2
Affiliation(s): 1Faculty of Medicine, Department of Public Health, 2Faculty of Medicine, Tbilisi State University, Georgia
Keywords: Inequality, access to healthcare, ageing
Background:

Increase of the elderly people number brings a sharp question of the main recourse. The mentioned situation creates serious problems for the society, because expenses, allocated for healthcare and social protection of the contingent is a hard burden to the country’s economy. The consequences of the economical crisis in Georgia have the most serious impact on persons over 60.

Summary/Objectives:

We have studies basic tendency of Georgian Population’s general structure, peculiarity of structure by sex and age, what determine demands of healthcare, trends of core health indicators, accessibility to healthcare.

Results:

In 1989 the Georgian population was at the medium level of demographic ageing (14.4%), during a very small period (5 years), in particular, in 1994 the index has reached level of ageing in developed countries (16.2%). From 2000 the very high level of ageing (18.4%) was evident and continuous to increase up till now. An absolute number of long livers goes up, their share in the population’s general structure is still high, and these tendencies are still the most prominent in indigenous Georgian population. In 1970-2006 population under 15 years was decreased by 1/3, from 31% to 21.5%, and share of the elderly population (65 and over) increased from 8% to 13%. Geriatric practice in older population increase risk of morbidity and polypathology. For the life of older population healthcare issues are very important. Interesting tendency is in the process of study of sex structure of 60-year and over age group. In 2006 this age group was constituted of women for 60%, 40% - men. With increase of the age interval, women’s share also increases. If in 60-64 year age group men were 43,21%, women 56,9%, in 100-year and over age group men were only 11,2%, women – 88,8%.
While the expenses on the social needs sharply shortened, the change of the ‘Soviet’ model of healthcare, which provided the population with free medical service for tens of years, took place. The new model of the healthcare payment was at first unacceptable both psychologically and economically. Persons over 60 have no means to buy neither expensive, nor cheap medicines, as well as different aid apparatus (hearing aid, glasses and other), it is absolutely inaccessible to purchase for them. Also it is inaccessible to get high quality out-patient and in-patient medical services.

Lessons learned:

Concerning the Caucasus long livers phenomena, Georgia even in the beginning of XXI century is the hearth of traditionally long liver population and reserves one of the leading places in the world twenty of long livers populations. This fact in spite of the difficult economic and social situation of transition period needs in-depth study-complex research of the Georgian long livers contingent, taking into account medical (especially Mental Health-Mild/Vascular Cognitive Impairment), social, economic, and psychological factor of their life.
It is necessary to carry out special measures to overcome poverty and eradicate extreme indigence through- out the country in the following directions: improvement of health policy and the system of access to healthcare for population under 60, reform of social security and the system of social assistance.

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