Factors influencing healthcare choices by the elderly in India: role of social interactions
Authors: Self Sharmistha , Basuroy Subhasree 
Published: July 2017

Purpose
The primary objective of this paper is to identify and analyze factors that influence choice and quality of healthcare of the elderly population in two northern and two southern states in India. The purpose of this paper is to look beyond the obvious factors that influence choice and therefore the quality of healthcare and seek to find whether there are some additional indirect factors that also influence choice and quality of healthcare.

Design/methodology/approach
This paper utilizes data from the Longitudinal Aging Study in India pilot project, which was a cross-sectional survey of men and women aged 45 and over focusing on two northern states (Punjab and Rajasthan) and two southern states (Kerala and Karnataka). In this paper the authors carry out a Probit analysis to estimate the factors that influence the elderly’s choice of healthcare.

Findings
The authors find that social activity via different types of social interactions outside the home and access to a phone (which is one of the cheapest and most commonly used methods of communication used by people in India) are statistically significant in influencing better quality of healthcare for the elderly. Moreover, gender-segregated results suggest that social activity is particularly important for elderly females. Relative price of healthcare is also an important determinant of the quality of healthcare sought. The authors also find some consistent regional influences on healthcare choices by the elderly.

Research limitations/implications
The main limitation is the data itself which is cross-sectional in nature. However, as further rounds of survey are conducted the authors hope to be able to build on the results of this paper using a longitudinal approach. A second limitation is the lack of variables available for carrying out an instrumental variables analysis. The results imply that elderly males and females are influenced by different things when it comes to healthcare choices. Thus for policy to be effective, the government needs to pursue avenues that would be most likely to succeed.

Practical implications
One of the most important practical implications of this research is the understanding that informal channels of knowledge transmission are important especially for the elderly in India. Traditional methods of knowledge transmission such as education, media, and income are less likely to be effective in a country where majority of the people are illiterate and poor. Social interactions appear to be most effective in influencing healthcare choices of elderly females.

Social implications
The most obvious social implications of this paper are the importance of social interactions via social activities outside the home and ability for social communication via access to a phone for the elderly population in India to make better healthcare choices and therefore receive better healthcare.

Originality/value
The literature on elderly healthcare is limited when it comes to developing countries. What makes matters worse for India is that up until recently there have been no comprehensive efforts to collect reliable data on the elderly population in India. As a result there is extremely limited availability of policy-relevant research dedicated to issues relating to the older population. Most of the existing literature looks at self-reported health and healthcare status or utilization. This paper would be among the first to address factors influencing quality of healthcare received by the elderly population in India.