Maintaining quality of life of people at older ages: factors affecting the utilization of preventive care

Abstract Background Maintaining and improving quality of life (QOL) in older people are among the goals of clinical management, achieved mainly through preventive care. Objective To analyze the association of individual-level disability and country-level health funding characteristics with the utilization of preventive care measures, including flu vaccines, eye exams, and dental care. Design and setting Data from the cross-sectional SHARE study (pre-COVID wave 8) were analyzed using a multi-level econometric approach. Explanatory variables included Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) disability reported by individuals and government health expenditure (GHE). Subjects The study included 46,498 participants 50 years and older residing in 27 high/middle income countries. Results Preventive care utilization greatly varied between countries; flu vaccinations ranged from 3–60%, eye exams from 17–77%, and dental care from 14–86%. Disability prevalence ranged from 7 to 26%. Individual-level analysis revealed a negative correlation between disability and all preventive care measures. Country-level analysis showed a positive and significant correlation between GHE and preventive care. The disability and GHE interaction analysis showed that for eye exams and dental care, higher GHE and lower disability led to higher utilization of preventive care. Contrastingly, in the case of flu vaccines in high GHE countries, higher disability correlated with higher care utilization. Conclusions Our findings emphasize the role of healthcare funding in enhancing preventive care use among older adults, though disparities remain for those with disabilities. Tailored policies addressing disability and healthcare investment can improve QOL through accessible preventive care among disabled populations.