Changes in Patterns of Health Care Use Among Older Adults in Singapore Across a Decade: Repeated Nationwide Cross-Sectional Survey

Abstract Background There is limited evidence on the patterns of health care use among older adults in Singapore over the past decade. Objective This study examines whether the proportion of specific services used within sociodemographic subgroups, the factors associated with health care use, and the network structure of health care use have changed over a decade. Methods We used data from 2 repeated nationwide cross-sectional surveys of Singapore residents aged 60 years and older, conducted in 2013 (n=2565) and 2023 (n=2010). Health care service use was obtained from an adapted version of the Client Service Receipt Inventory and analyzed using multivariable logistic regression and network analysis. Results The most significant changes between 2013 and 2023 were in the proportions of older adults who had consulted private hospital/clinic doctors (decreased by 4.6 percentage points; n=655, 26.5% vs n=425, 21.9%; P =.02), consulted public and private dentists (increased by 6.4 percentage points; n=215, 11.6% vs n=269, 18%; P <.001), and had health insurance (increased by 26.9 percentage points; n=1312, 59.9% vs n=1697, 86.8%; P <.001). Those diagnosed with high blood pressure and diabetes were more likely to consult primary care doctors, while those diagnosed with dementia and heart problems were more likely to consult public hospital doctors and health workers, visit emergency departments, and require hospitalization services in both 2013 and 2023. We also found that those diagnosed with dementia were more likely to visit intermediate and long-term care services in both 2013 and 2023. Network analysis revealed that there were strong connections between respite care, nursing homes, and hospital admissions in 2023. Conclusions This study provides important data on population-level changes in health care usage among older adults across the decade from 2013 to 2023, which will help policymakers ensure better health care delivery for older adults.