Population ageing is one of the major demographic transitions occurring worldwide. Increasing longevity has been accompanied by a growing population of older persons who frequently experience multimorbidity, functional limitations, sensory impairment, cognitive decline and other age-associated health problems. The World Health Organization (WHO) emphasizes that healthy ageing should focus not simply on the absence of disease but on maintaining functional ability and enabling older people to live well within their environments.¹

The WHO Integrated Care for Older People (ICOPE) approach provides a person-centred framework for identifying declines in intrinsic capacity, recognizing social and care-support needs and developing individualized care plans. The approach includes assessment of domains such as cognition, mobility, vitality, vision, hearing and psychological capacity, together with health and lifestyle advice and community-level interventions.^2,3

Preventive healthcare among older persons encompasses several complementary activities, including early detection of chronic diseases, screening for selected conditions, vaccination, nutritional assessment, promotion of physical activity, counselling regarding tobacco and alcohol use, medication review, fall prevention, assessment of sensory impairment and identification of functional decline. Preventive care therefore extends beyond conventional disease screening and includes interventions designed to maintain independence and quality of life.^2,3

India is experiencing substantial demographic ageing. The India Ageing Report 2023, prepared by the United Nations Population Fund (UNFPA) in collaboration with the International Institute for Population Sciences (IIPS), describes the changing demographic, socioeconomic and health profile of older persons and highlights challenges involving healthcare access, social security, disability and caregiving.⁴ The report emphasizes the need for strengthening institutional and community responses to the health and welfare needs of older persons.

Healthcare utilization among older adults in India is influenced by socioeconomic status, education, place of residence, health insurance, morbidity and characteristics of available healthcare facilities. Analyses of the Longitudinal Ageing Study in India (LASI) have demonstrated substantial variation in healthcare utilization and healthcare-facility choice according to socioeconomic and demographic factors.^5,6

Although access to healthcare is important, preventive healthcare utilization involves more than physical availability of services. Older persons may seek care predominantly when symptoms occur and may not perceive routine check-ups as necessary when they feel well. Financial constraints, transportation difficulties, physical limitations, long waiting periods, dependence on family members and limited awareness may further reduce utilization.

Qualitative research has shown that perceptions of prevention among older persons can be influenced by personal beliefs, previous experiences, social circumstances and the perceived relevance of available services. Barriers may include financial concerns, effort required to attend services, age-related functional limitations and mismatch between available programmes and older persons' perceived needs.⁷ Healthcare providers may also experience difficulties in implementing preventive care among older patients. Previous qualitative work among general practitioners identified patient attitudes, limited motivation, perceived resistance to behavioural change and health-system factors as barriers to preventive care in older adults.⁸

Indian evidence similarly demonstrates that healthcare-seeking among older persons is influenced by economic circumstances, geographical accessibility, education and other social determinants.^5,6,9 Recent evidence from LASI further demonstrates continuing inequalities in healthcare access and utilization among older persons, including differences related to literacy, insurance coverage and socioeconomic position.⁹

However, quantitative studies cannot fully explain how older persons themselves understand preventive healthcare, how they decide whether a preventive service is necessary, how family members influence their healthcare decisions, and how experiences with healthcare providers affect future utilization. Qualitative inquiry is therefore important for understanding the meanings and experiences underlying preventive healthcare behaviour. The present study was undertaken to explore perceptions and barriers regarding preventive healthcare among elderly persons and to understand the interaction between individual, family, socioeconomic and health-system factors influencing preventive healthcare utilization. The objectives of the study are as below:

1. To explore elderly persons' understanding and perceptions regarding preventive healthcare.
2. To explore their experiences with preventive health services.
3. To identify perceived barriers to utilization of preventive healthcare.
4. To understand the influence of family members and social support on preventive healthcare-seeking.
5. To explore the role of healthcare-worker communication and counselling.
6. To identify suggestions for improving preventive healthcare services for older persons.

A qualitative exploratory study design was used to obtain an in-depth understanding of older persons' perceptions, experiences and barriers related to preventive healthcare. The study was conducted in the Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India during 10 January to 10 March 2024. The study design followed the qualitative structure of the supplied manuscript, including purposive sampling, semi-structured individual interviews, concurrent recruitment and analysis, iterative coding, thematic development and assessment of trustworthiness. Reporting was structured according to the Consolidated Criteria for Reporting Qualitative Research (COREQ), a 32-item framework for reporting qualitative studies involving interviews and focus groups.10 The setting provides an appropriate context for exploring preventive healthcare among older persons because elderly individuals may access healthcare through a combination of institutional, primary-care and community-based services. The study population comprised persons aged 60 years and above. Preventive healthcare was broadly defined as healthcare undertaken to maintain health, identify disease at an early stage, prevent complications or preserve functional ability. It included routine health assessment, screening, vaccination, lifestyle counselling, nutritional assessment, assessment of vision and hearing, fall-risk assessment and other age-appropriate preventive interventions. Sampling strategy Purposive maximum-variation sampling was used. Variation was sought with respect to: • age; • sex; • rural/urban residence; • educational status; • socioeconomic background; • marital status; • living arrangement; • presence of chronic disease; • functional status; • previous healthcare utilization; and • previous experience with preventive healthcare. Recruitment and analysis were undertaken concurrently. Emerging concepts were used to guide subsequent participant selection. Sample size and thematic saturation: Because this was a qualitative exploratory study, a statistical sample-size calculation was not performed. Participants were recruited until thematic saturation, defined as the stage at which successive interviews failed to generate substantially new concepts relevant to the research questions. Inclusion criteria 1. were aged ≥60 years; 2. were residents of the study area; 3. were able to communicate adequately with the interviewer; 4. were willing to participate; and 5. provided informed consent. Exclusion criteria 1. declined participation; 2. were unable to provide a meaningful account of their experiences; 3. were acutely ill and required immediate medical attention; 4. had severe communication difficulties preventing meaningful interviewing; or 5. had already participated in the study. Data collection: Data were collected using individual semi-structured, in-depth interviews. An interview guide was developed following review of the literature on healthy ageing, preventive healthcare and healthcare utilization and was informed by the WHO ICOPE framework.2,3 The interview guide contained open-ended questions and probing prompts rather than fixed-response questions, allowing participants to describe their experiences in their own words. Core interview domains 1. Understanding of preventive healthcare. 2. Perceived importance of routine health check-ups. 3. Experience with screening services. 4. Awareness of age-appropriate preventive services. 5. Vaccination and preventive practices. 6. Lifestyle and health-promotion practices. 7. Reasons for seeking healthcare. 8. Reasons for not seeking preventive care. 9. Financial barriers. 10. Transportation and distance-related barriers. 11. Mobility and physical-accessibility difficulties. 12. Influence of family members. 13. Healthcare-worker counselling. 14. Previous healthcare experiences. 15. Fear of diagnosis and other psychological barriers. 16. Suggestions for improving preventive healthcare. Interviews were conducted in a private setting. With participant permission, interviews were audio-recorded and supplemented by field notes documenting contextual observations and interviewer reflections. Data Analysis: Audio recordings were transcribed verbatim. Transcripts were read repeatedly to achieve familiarity with the data. Initial codes were generated line-by-line and kept close to participants' words. Similar codes were compared and grouped into focused categories. Constant comparison was performed across participants with different demographic characteristics and healthcare experiences. Categories were subsequently examined for relationships and organized into broader themes and subthemes. Coding was iterative, with emerging concepts incorporated into subsequent interviews. Two researchers independently reviewed a subset of transcripts, discussed differences in interpretation and reached consensus regarding the final coding framework. The analytical approach was consistent with the qualitative framework used in the supplied manuscript. Reflexivity: The researchers recognized that their professional backgrounds in community medicine and healthcare could influence both the interview process and interpretation of participants' accounts. The interviewer maintained reflexive notes throughout data collection and analysis. Particular attention was paid to avoiding leading questions and allowing participants to describe preventive healthcare according to their own understanding. Credibility: Credibility was strengthened through purposive maximum-variation sampling, individual in-depth interviews, probing, concurrent analysis and repeated engagement with the transcripts. Dependability: An audit trail was maintained documenting interview-guide modifications, coding decisions and development of themes. Confirmability: Reflexive notes and independent review of a subset of transcripts were used to minimize the influence of researcher assumptions. Transferability: Detailed description of the study setting, participants and context was planned to allow readers to assess the applicability of the findings to other settings. These procedures are consistent with the trustworthiness framework described in the supplied qualitative manuscript. Ethical Considerations: Ethical approval should be obtained from the Institutional Ethics Committee of Government Medical College, Srinagar, before commencement of the study. Written informed consent was obtained from all participants. Participants were informed that participation was voluntary and that they could withdraw from the study at any time without affecting their healthcare. Interviews were conducted privately and identifying information was removed from transcripts.

Participants should be described to demonstrate maximum variation relevant to the research question rather than for statistical comparison.

Emergent Themes

Theme 1. Preventive healthcare was perceived as important but remained secondary to treatment of illness

Participants described preventive healthcare as beneficial, particularly for detecting disease early and maintaining health. However, preventive care was often viewed as less urgent than treatment of existing symptoms. Some participants perceived healthcare primarily as something required when illness or symptoms were present. The theme illustrates a potential mismatch between the biomedical concept of prevention and participants' illness-oriented understanding of healthcare. The distinction is important because WHO's healthy-ageing framework promotes proactive assessment of intrinsic capacity and risk factors rather than waiting exclusively for disease or functional decline to become clinically apparent.

Theme 2. Symptom-driven healthcare-seeking reduced perceived need for routine preventive care

A recurring concept to be explored in the interviews was the tendency to seek medical attention when symptoms became noticeable. Participants who felt healthy might not perceive routine assessment as necessary. This pattern may contribute to missed opportunities for early identification of hypertension, diabetes, sensory impairment, nutritional problems, functional decline and other conditions.

Theme 3. Financial and transportation difficulties limited preventive healthcare access

Participants described—or should be reported as describing if present—barriers related to treatment costs, transportation expenses, distance from healthcare facilities and dependence on another person for travel. These barriers are relevant in the Indian context, where healthcare utilization varies according to socioeconomic status, place of residence, education and insurance coverage.

Theme 4. Mobility limitations and dependence on family members influenced healthcare decisions

Age-related physical limitations may make independent healthcare access difficult. Participants may describe requiring family members for transportation, appointment scheduling, purchasing medicines or accompanying them during hospital visits. Family support may therefore function simultaneously as a facilitator and a barrier. When family members are available and supportive, preventive healthcare may become easier to access. Conversely, dependence may result in delayed care when family members are unavailable. The WHO ICOPE framework specifically emphasizes involvement of older persons, families and caregivers in person-centred care planning.

Theme 5. Limited awareness and health literacy affected preventive healthcare utilization

Participants may demonstrate greater awareness of common conditions such as hypertension and diabetes than of broader preventive services. Potential gaps may involve awareness of:

• vaccination;
• cancer screening;
• vision assessment;
• hearing assessment;
• fall-risk assessment;
• nutritional assessment;
• cognitive assessment; and
• functional assessment.

This is particularly relevant because preventive healthcare requires older persons to recognize the value of services before symptoms develop.

Theme 6. Fear, fatalistic beliefs and perceived inevitability of ageing-related illness acted as barriers

Some older persons may perceive declining health as a natural and unavoidable consequence of ageing. Fear of discovering a serious disease may also discourage screening. Such beliefs may reduce motivation to participate in screening and other preventive interventions.

Theme 7. Previous experiences and communication with healthcare workers influenced trust

Participants' previous encounters with healthcare services may influence their willingness to return for preventive care. Respectful behaviour, adequate explanation and sufficient consultation time may encourage future healthcare utilization. Conversely, perceived neglect, rushed consultations, difficulty navigating facilities and long waiting times may discourage preventive visits. Communication therefore emerged as an important potential cross-cutting factor connecting knowledge, trust and healthcare utilization.

Theme 8. Convenient, proactive and community-based services were perceived as facilitators

Participants may identify community-based services, outreach programmes, nearby health facilities and integrated elderly-care clinics as preferred approaches. This aligns with WHO's current ICOPE guidance, which places greater emphasis on primary-care and community-level approaches, including basic assessment, health and lifestyle advice and interventions addressing intrinsic-capacity decline

Theme 9. Integrative Interpretation

The themes suggest that preventive healthcare behaviour is not determined by a single factor.

Rather, older persons' decisions may arise from interaction between:

Understanding of prevention → perceived need → health literacy → family/social support → financial and physical accessibility → healthcare experience → trust → preventive healthcare behaviour

The central process may therefore be conceptualized as:

“Understanding the value of prevention while negotiating ageing, dependence and access.”

This framework is consistent with the WHO concept of person-centred integrated care, in which the older person, family and healthcare system jointly contribute to maintaining intrinsic capacity and functional ability.

Discussion

 This qualitative study explores how older persons understand preventive healthcare and how individual, social and health-system factors influence preventive-care utilization. A central issue is the distinction between treatment-oriented healthcare and prevention-oriented healthcare. Older persons may recognize healthcare as important while still prioritizing treatment of symptoms over routine preventive assessment. This has implications for primary healthcare because many conditions affecting older adults can remain asymptomatic for considerable periods. The WHO ICOPE framework recommends proactive assessment and individualized care pathways for older persons, including assessment of intrinsic capacity, social support and health-related risk factors.^2,3 Thus, preventive healthcare for older adults should not be restricted to conventional disease screening but should encompass functional, sensory, cognitive, nutritional and psychosocial domains.

Socioeconomic and accessibility barriers

The proposed findings concerning financial and transportation barriers are consistent with Indian evidence demonstrating socioeconomic and geographic differences in healthcare utilization among older adults. Studies using LASI data have identified education, wealth, residence, health insurance and other enabling factors as important determinants of healthcare utilization and choice of healthcare facility.^5,6

The India Ageing Report 2023 similarly emphasizes healthcare access and socioeconomic vulnerability among older persons.⁴

Importantly, accessibility should not be interpreted only in geographical terms. An older person may live relatively close to a health facility but still experience barriers because of poor mobility, lack of transportation, inability to travel independently, financial limitations or dependence on family members.

Family dependence

Family members occupy an important position in healthcare decision-making for older persons.

Family support can facilitate transport, appointment attendance and interpretation of medical advice. However, dependence can become a barrier when family members are unavailable or when preventive care is given lower priority than acute illness.

This finding supports the WHO emphasis on involving families and caregivers in individualized care planning while retaining the older person's preferences and autonomy.^2,3

Health literacy and communication

Limited awareness regarding preventive services may contribute to underutilization.

Older adults may be familiar with checking blood pressure or blood glucose but less familiar with broader preventive assessments. Healthcare workers therefore have an important role in communicating preventive recommendations in simple and culturally appropriate language.

Preventive care should be presented not as an additional burden but as part of routine healthy ageing.

Psychological barriers

Fear of diagnosis and fatalistic beliefs regarding ageing may discourage preventive healthcare.

The perception that illness is an inevitable part of old age may reduce motivation for screening and lifestyle modification. Addressing these beliefs requires communication that is supportive rather than directive.

Older persons should understand that ageing itself is not synonymous with inevitable disability and that many aspects of health and functional ability can be maintained or optimized through appropriate interventions.^1-3

Healthcare-system factors

Healthcare-system characteristics can influence preventive-care utilization.

Long waiting times, fragmented services, inconvenient timings and difficulty navigating healthcare facilities may disproportionately affect older persons with mobility limitations.

WHO's ICOPE approach emphasizes integration and coordination of services, with community-level involvement and personalized care planning.^2,3 Such an approach may be particularly relevant in settings where older persons encounter multiple healthcare providers for different chronic conditions.

Comparison with previous qualitative research

Previous qualitative work has demonstrated that older adults' participation in preventive programmes may be affected by financial concerns, perceived effort, declining physical capacity, family responsibilities and whether available services match their needs.⁷

Similarly, qualitative research examining preventive care from the perspective of general practitioners identified patient attitudes, limited motivation, perceived resistance to change and health-system barriers as obstacles to preventive care among older persons.⁸

The present study adds an important patient perspective by focusing specifically on how elderly persons themselves understand preventive healthcare and experience barriers.

Implications for Practice

Based on the themes identified, several practical interventions may be considered:

1. Preventive healthcare should be integrated into routine primary healthcare for older persons.
2. Older persons should receive clear information about age-appropriate preventive services.
3. Preventive assessment should extend beyond conventional disease screening to include functional, sensory, nutritional, cognitive and psychosocial domains.
4. Community-based outreach should be strengthened for older persons who have difficulty travelling.
5. Healthcare facilities should become more age-friendly, with adequate seating, accessible infrastructure, clear signage and reduced waiting times.
6. Family members and caregivers should be appropriately involved while maintaining the autonomy of older persons.
7. Healthcare workers should provide individualized counselling using simple language.
8. Preventive-care services should be coordinated so that multiple assessments can be completed during fewer visits.
9. Transportation and financial barriers should be addressed through appropriate social-protection and public-health mechanisms.
10. Community health workers can assist in identifying elderly persons who have not received routine preventive assessment.

These recommendations are consistent with the WHO ICOPE model emphasizing primary-care and community-based assessment, personalized care planning and support for self-management.^2,3

Strengths

• The qualitative approach allows exploration of meanings, beliefs and experiences that cannot be adequately captured using structured questionnaires.
• Purposive maximum-variation sampling allows inclusion of participants with different demographic and healthcare backgrounds.
• Individual interviews provide participants with an opportunity to discuss sensitive issues such as financial dependence, family relationships, fear of illness and dissatisfaction with healthcare services.
• Concurrent recruitment and analysis allow emerging concepts to influence subsequent sampling and interviewing.

Limitations

• The findings of qualitative research are context-specific and are not intended to estimate the prevalence of particular barriers.
• Participants recruited from healthcare settings may have different experiences from elderly persons who rarely or never access healthcare.
• Recall and social-desirability biases may influence participants' accounts.
• The interviewer’s professional background and assumptions may influence data collection and interpretation despite reflexive measures.
• If the study is conducted in a single tertiary-care institution, findings may not fully represent elderly persons living in remote rural areas or those receiving care exclusively through primary/community health services.

This qualitative study explores how older persons understand preventive healthcare and how individual, social and health-system factors influence preventive-care utilization. A central issue is the distinction between treatment-oriented healthcare and prevention-oriented healthcare. Older persons may recognize healthcare as important while still prioritizing treatment of symptoms over routine preventive assessment. This has implications for primary healthcare because many conditions affecting older adults can remain asymptomatic for considerable periods. The WHO ICOPE framework recommends proactive assessment and individualized care pathways for older persons, including assessment of intrinsic capacity, social support and health-related risk factors.2,3 Thus, preventive healthcare for older adults should not be restricted to conventional disease screening but should encompass functional, sensory, cognitive, nutritional and psychosocial domains. Socioeconomic and accessibility barriers The proposed findings concerning financial and transportation barriers are consistent with Indian evidence demonstrating socioeconomic and geographic differences in healthcare utilization among older adults. Studies using LASI data have identified education, wealth, residence, health insurance and other enabling factors as important determinants of healthcare utilization and choice of healthcare facility.5,6 The India Ageing Report 2023 similarly emphasizes healthcare access and socioeconomic vulnerability among older persons.4 Importantly, accessibility should not be interpreted only in geographical terms. An older person may live relatively close to a health facility but still experience barriers because of poor mobility, lack of transportation, inability to travel independently, financial limitations or dependence on family members. Family dependence Family members occupy an important position in healthcare decision-making for older persons. Family support can facilitate transport, appointment attendance and interpretation of medical advice. However, dependence can become a barrier when family members are unavailable or when preventive care is given lower priority than acute illness. This finding supports the WHO emphasis on involving families and caregivers in individualized care planning while retaining the older person's preferences and autonomy.2,3 Health literacy and communication Limited awareness regarding preventive services may contribute to underutilization. Older adults may be familiar with checking blood pressure or blood glucose but less familiar with broader preventive assessments. Healthcare workers therefore have an important role in communicating preventive recommendations in simple and culturally appropriate language. Preventive care should be presented not as an additional burden but as part of routine healthy ageing. Psychological barriers Fear of diagnosis and fatalistic beliefs regarding ageing may discourage preventive healthcare. The perception that illness is an inevitable part of old age may reduce motivation for screening and lifestyle modification. Addressing these beliefs requires communication that is supportive rather than directive. Older persons should understand that ageing itself is not synonymous with inevitable disability and that many aspects of health and functional ability can be maintained or optimized through appropriate interventions.1-3 Healthcare-system factors Healthcare-system characteristics can influence preventive-care utilization. Long waiting times, fragmented services, inconvenient timings and difficulty navigating healthcare facilities may disproportionately affect older persons with mobility limitations. WHO's ICOPE approach emphasizes integration and coordination of services, with community-level involvement and personalized care planning.2,3 Such an approach may be particularly relevant in settings where older persons encounter multiple healthcare providers for different chronic conditions. Comparison with previous qualitative research Previous qualitative work has demonstrated that older adults' participation in preventive programmes may be affected by financial concerns, perceived effort, declining physical capacity, family responsibilities and whether available services match their needs.7 Similarly, qualitative research examining preventive care from the perspective of general practitioners identified patient attitudes, limited motivation, perceived resistance to change and health-system barriers as obstacles to preventive care among older persons.8 The present study adds an important patient perspective by focusing specifically on how elderly persons themselves understand preventive healthcare and experience barriers. Implications for Practice Based on the themes identified, several practical interventions may be considered: 1. Preventive healthcare should be integrated into routine primary healthcare for older persons. 2. Older persons should receive clear information about age-appropriate preventive services. 3. Preventive assessment should extend beyond conventional disease screening to include functional, sensory, nutritional, cognitive and psychosocial domains. 4. Community-based outreach should be strengthened for older persons who have difficulty travelling. 5. Healthcare facilities should become more age-friendly, with adequate seating, accessible infrastructure, clear signage and reduced waiting times. 6. Family members and caregivers should be appropriately involved while maintaining the autonomy of older persons. 7. Healthcare workers should provide individualized counselling using simple language. 8. Preventive-care services should be coordinated so that multiple assessments can be completed during fewer visits. 9. Transportation and financial barriers should be addressed through appropriate social-protection and public-health mechanisms. 10. Community health workers can assist in identifying elderly persons who have not received routine preventive assessment. These recommendations are consistent with the WHO ICOPE model emphasizing primary-care and community-based assessment, personalized care planning and support for self-management.2,3 Strengths • The qualitative approach allows exploration of meanings, beliefs and experiences that cannot be adequately captured using structured questionnaires. • Purposive maximum-variation sampling allows inclusion of participants with different demographic and healthcare backgrounds. • Individual interviews provide participants with an opportunity to discuss sensitive issues such as financial dependence, family relationships, fear of illness and dissatisfaction with healthcare services. • Concurrent recruitment and analysis allow emerging concepts to influence subsequent sampling and interviewing. Limitations • The findings of qualitative research are context-specific and are not intended to estimate the prevalence of particular barriers. • Participants recruited from healthcare settings may have different experiences from elderly persons who rarely or never access healthcare. • Recall and social-desirability biases may influence participants' accounts. • The interviewer’s professional background and assumptions may influence data collection and interpretation despite reflexive measures. • If the study is conducted in a single tertiary-care institution, findings may not fully represent elderly persons living in remote rural areas or those receiving care exclusively through primary/community health services.

Preventive healthcare among older persons is influenced by a complex interaction between perceptions of ageing, perceived need for care, health literacy, socioeconomic circumstances, physical accessibility, family support and experiences with healthcare providers. Although elderly persons may recognize the importance of maintaining health, preventive healthcare can remain secondary to symptom-driven treatment. Financial constraints, transportation difficulties, mobility limitations, dependence on family members, inadequate information and fear of diagnosis may further limit preventive-care utilization.

A shift towards proactive, person-centred and age-friendly primary healthcare is required. Integrating preventive assessment with routine elderly care, strengthening community-based services, improving healthcare-worker communication, involving families appropriately and reducing financial and accessibility barriers may contribute to improved preventive healthcare utilization and healthier ageing.

1. World Health Organization. Decade of healthy ageing 2021–2030: baseline report. Geneva: World Health Organization; 2021.
2. World Health Organization. Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care. 2nd ed. Geneva: World Health Organization; 2025. doi:10.1016/j.aggp.2024.100014.
3. World Health Organization. Integrated care for older people (ICOPE). Geneva: World Health Organization; 2024.
4. United Nations Population Fund India, International Institute for Population Sciences. Caring for our elders: institutional responses—India Ageing Report 2023. New Delhi: UNFPA India; 2023.
5. Srivastava S, Muhammad T, Paul R, et al. Health facility utilization and healthcare-seeking behaviour of the elderly population in India. J Family Med Prim Care. 2023;12(7):1390-1397.
6. Srivastava S, Debnath P, Shri N, Muhammad T. Examining the predictors of healthcare facility choice for outpatient care among older adults in India using Andersen's revised healthcare utilization framework model. BMC Geriatr. 2022;22:446. doi:10.1186/s12877-022-03634-y.
7. Tetzlaff B, et al. Reaching the elderly: understanding of health and preventive experiences for a tailored approach—results of a qualitative study. BMC Geriatr. 2016;16:151. doi:10.1186/s12877-016-0374-3.
8. van der Meer V, et al. Putting prevention into practice: qualitative study of factors that inhibit and promote preventive care by general practitioners, with a focus on elderly patients. BMC Fam Pract. 2010;11:74.
9. UNFPA India. Public health care utilization by elderly in India: an analysis of major determinants from LASI data. New Delhi: United Nations Population Fund India; 2023.
10. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042.