BACKGROUND Like many other low- and middle-income countries (LMICs), the Ghanaian healthcare system remains poor which is likely to affect the utilisation of healthcare services, especially among poor older people who are faced with multiple health problems. Yet, factors that explain healthcare use among poor older people in LMICs, particularly Ghana remain largely unexplored. Understanding the predictors of healthcare use among poor older people could have a huge impact on health policies in LMICs including Ghana. This study, therefore, examined factors associated with healthcare use among poor older people under the Livelihood Empowerment Against Poverty (LEAP) programme in the Atwima Nwabiagya District of Ghana. METHODS Cross-sectional data were obtained from an Ageing, Health, Lifestyle and Health Services (AHLHS) study conducted between 1 and 20 June 2018 (N = 200) in Atwima Nwabiagya District, Ghana. Sequential logistic regression models were performed to estimate the variables that predict healthcare use among poor older people. All test results were considered significant at 0.05 or less. RESULTS The fully adjusted model showed that respondents aged 85-89 years (AOR = 0.094, CI: 0.007-1.170), acquired basic education (AOR =0.251, CI: 0.085-0.987), received no family support (AOR = 0.771, CI: 0.120-0.620), with no past illness records (AOR = 0.236, CI: 0.057-0.197) and who were not diagnosed of chronic non-communicable diseases (AOR = 0.418, CI: 0.101-0.723) were significantly less likely to utilise health facility compared with their respective counterparts. Moreover, those with no disability (AOR = 19.245, CI: 2.415-29.921) and who consumed low fruits (AOR = 1.435 = CI: 0.552-8.740) and vegetables (AOR = 1.202 = CI: 0.362-10.20) had a higher likelihood to use healthcare. CONCLUSION The study has outlined multiple factors influencing utilisation of healthcare among poor older people under the LEAP programme in Ghana. The results, therefore, validate the importance of social and behavioural determinants of healthcare use in the Ghanaian poor older population. We highlight the need for health planners and stakeholders to consider demographic, socio-economic, health-related and lifestyle factors when formulating health policy for poor older people in Ghana.

中文翻译：

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加纳 Atwima Nwabiagya 地区生计赋权反贫困计划中贫困老年人医疗保健利用率的预测。

背景与许多其他低收入和中等收入国家（LMIC）一样，加纳的医疗保健系统仍然很差，这可能会影响医疗保健服务的利用，特别是面临多种健康问题的贫困老年人。然而，解释中低收入国家（尤其是加纳）贫困老年人使用医疗保健的因素在很大程度上仍未得到探索。了解贫困老年人医疗保健使用的预测因素可能会对包括加纳在内的中低收入国家的卫生政策产生巨大影响。因此，本研究调查了加纳 Atwima Nwabiagya 区生计赋权反贫困 (LEAP) 计划下贫困老年人使用医疗保健的相关因素。方法 横断面数据取自 2018 年 6 月 1 日至 20 日（N = 200）在加纳 Atwima Nwabiagya 区进行的老龄化、健康、生活方式和健康服务 (AHLHS) 研究。采用序贯逻辑回归模型来估计预测贫困老年人医疗保健使用情况的变量。所有测试结果在 0.05 或更低时均被认为是显着的。结果完全调整后的模型显示，受访者年龄在85-89岁（AOR=0.094，CI：0.007-1.170），受过基础教育（AOR=0.251，CI：0.085-0.987），没有得到家庭支持（AOR=0.771，CI） ：0.120-0.620），没有既往病史（AOR = 0.236，CI：0.057-0.197）且未诊断出患有慢性非传染性疾病（AOR = 0.418，CI：0.101-0.723）的人使用该药物的可能性明显较低卫生机构与各自对应机构的比较。此外，那些没有残疾的人（AOR = 19.245，CI：2.415-29.921）和食用水果（AOR = 1.435 = CI：0.552-8.740）和蔬菜（AOR = 1.202 = CI：0.362-10.20）的人有更高的可能性使用医疗保健。结论 该研究概述了影响加纳 LEAP 计划下贫困老年人医疗保健利用的多种因素。因此，结果验证了加纳贫困老年人群中医疗保健使用的社会和行为决定因素的重要性。我们强调健康规划者和利益相关者在为加纳贫困老年人制定健康政策时需要考虑人口、社会经济、健康相关和生活方式因素。