Besjan Elezaj1, Herjon Muja1, Genc Burazeri2, Alban Ylli1,2
1Institute of Public Health, Tirana, Albania;
2Faculty of Medicine,University of Medicine, Tirana, Albania.
Aim: Albania is one of the last countries in Europe to experience effects of population ageing. The proportion of the population over 65 years of age in Albania rose more than three times during last 25 years. Prevalence of a number of health conditions is expected to be higher among older people and most of them can be addressed at primary health care. We use data from two surveys carried out among older people to quantify their health and social needs as well as access to primary health care in three regions of Albania.
Methods: There are two cross sectional surveys carried out in 2008 and 2017. Their methodology is similar and comprises the subjective measuring of a range of health and social problems by means of a questionnaire. The sample in both surveys was made of around 1000 persons over 65 years old randomly selected from a number of health centres catchment areas. The sampling was limited to the regions of Tirana, Vlora and Shkodra. The comparison is used for variables which are identical or similar in both surveys.
Results: In 2017 15.8% of older people had not contacted a doctor in primary health care although felt sick. This is a net improvement compared to 25% of older people in 2008 study reporting not to contact their doctor when needed. The problem was higher for women than for man (17% vs. 14%) and in rural compared to urban areas (25% vs. 14%). In 201724.7% of participants reported that they could not take prescribed drugs, mainly because they could not afford them. The level of inability to pay for drugs was higher in rural areas and informal areas (about 28% and 31%, respectively). In 2008 study the rates were much higher at about 65% of older people not being able to get the medicines.
Conclusions:The population based data for this age group have been traditionally scarce and this work provides an unique opportunity to observe health care needs and utilization of primary health care. The results show an improvement in access of older people to basic health care services. Nevertheless, there is still a large proportion of older people avoiding the visit to the doctor and taking the prescribed medicines demonstrating the existence of significant barriers in utilization of health care. Primary health care in Albania needs to be adapted to demographic changes in the country and specific needs of older people.
Keywords: health needs, older people,primary health care, population-based survey.